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Mace RA, Lyons C, Cohen JE, Ritchie C, Bartels S, Okereke OI, Hoeppner BB, Brewer JA, Vranceanu AM. Optimizing the Implementation of a Lifestyle Dementia Prevention Intervention for Older Patients in an Academic Healthcare System. J Alzheimers Dis 2024:JAD240365. [PMID: 39031363 DOI: 10.3233/jad-240365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Background Interventions that promote healthy lifestyles are critical for the prevention of Alzheimer's disease and Alzheimer's disease related dementias (AD/ADRD). However, knowledge of the best practices for implementing AD/ADRD prevention in healthcare settings remains limited. Objective We aimed to qualitatively identify barriers and facilitators to implementing a clinical trial of a novel lifestyle intervention (My Healthy Brain) in our medical center for older patients with subjective cognitive decline who are at-risk for AD/ADRD. Methods We conducted focus groups with 26 healthcare professionals (e.g., physicians, psychology, nursing) from 5 clinics that treat older patients (e.g., memory care, psychiatry). Our qualitative analysis integrated two implementation frameworks to systematically capture barriers and facilitators to AD/ADRD prevention (Consolidated Framework for Implementation Science Research) that impact implementation outcomes of acceptability, appropriateness, and feasibility (Proctor's framework). Results We found widespread support for an RCT of My Healthy Brain and AD/ADRD prevention. Participants identified barriers related to patients (stigma, technological skills), providers (dismissiveness of "worried well," doubting capacity for behavior change), clinics (limited time and resources), and the larger healthcare system (underemphasis on prevention). Implementation strategies guided by Expert Recommendations for Implementing Change (ERIC) included: developing tailored materials, training staff, obtaining buy-in from leadership, addressing stigmatized language and practices, identifying "champions," and integrating with workflows and resources. Conclusions The results will inform our recruitment, enrollment, and retention procedures to implement the first randomized clinical trial of My Healthy Brain. Our study provides a blueprint for addressing multi-level barriers to the implementation of AD/ADRD prevention for older patients in medical settings.
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Affiliation(s)
- Ryan A Mace
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christopher Lyons
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Joshua E Cohen
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Christine Ritchie
- Harvard Medical School, Boston, MA, USA
- Mongan Institute Center for Aging and Serious Illness, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Stephen Bartels
- Harvard Medical School, Boston, MA, USA
- Mongan Institute Center for Aging and Serious Illness, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Bettina B Hoeppner
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Judson A Brewer
- Mindfulness Center, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Chyr LC, Wolff JL, Zissimopoulos JM, Drabo EF. Analysis of agreement between measures of subjective cognitive impairment and probable dementia in the National Health and Aging Trends Study. Alzheimers Dement 2024; 20:2817-2829. [PMID: 38426381 PMCID: PMC11032562 DOI: 10.1002/alz.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/03/2024] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Subjective cognitive impairment (SCI) measures in population-based surveys offer potential for dementia surveillance, yet their validation against established dementia measures is lacking. METHODS We assessed agreement between SCI and a validated probable dementia algorithm in a random one-third sample (n = 1936) of participants in the 2012 National Health and Aging Trends Study (NHATS). RESULTS SCI was more prevalent than probable dementia (12.2% vs 8.4%). Agreement between measures was 90.0% and of substantial strength. Misclassification rates were higher among older and less-educated subgroups due to higher prevalence of false-positive misclassification but did not vary by sex or race and ethnicity. DISCUSSION SCI sensitivity (63.4%) and specificity (92.5%) against dementia were comparable with similar metrics for the NHATS probable dementia measure against the "gold-standard" Aging, Demographics, and Memory Study-based dementia criteria, implying that population-based surveys may afford cost-effective opportunities for dementia surveillance to assess risk and inform policy. HIGHLIGHTS The prevalence of subjective cognitive impairment (SCI) is generally higher than that of a validated measure of probable dementia, particularly within the youngest age group, females, Whites, and persons with a college or higher degree. Percent agreement between SCI and a validated measure of probable dementia was 90.0% and of substantial strength (prevalence- and bias-adjusted kappa, 0.80). Agreement rates were higher in older and less-educated subgroups, driven by the higher prevalence of false-positive disagreement, but did not vary significantly by sex or race and ethnicity. SCI's overall sensitivity and specificity were 63.4% and 92.5%, respectively, against a validated measure of probable dementia, suggesting utility as a low-cost option for dementia surveillance. Heterogeneity in agreement quality across subpopulations warrants caution in its use for subgroup analyses.
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Affiliation(s)
- Linda C. Chyr
- Enterprise Analytics Core, Elevance Health, Inc.WilmingtonDelawareUSA
| | - Jennifer L. Wolff
- Department of Health Policy and ManagementJohn Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Julie M. Zissimopoulos
- Sol Price School of Public PolicyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Leonard D. Schaeffer Center for Health PolicyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Emmanuel F. Drabo
- Department of Health Policy and ManagementJohn Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
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Finley JCA, Cladek A, Gonzalez C, Brook M. Perceived cognitive impairment is related to internalizing psychopathology but unrelated to objective cognitive performance among nongeriatric adults presenting for outpatient neuropsychological evaluation. Clin Neuropsychol 2024; 38:644-667. [PMID: 37518890 DOI: 10.1080/13854046.2023.2241190] [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: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
Objective: This study investigated the relationship between perceived cognitive impairment, objective cognitive performance, and intrapersonal variables thought to influence ratings of perceived cognitive impairment. Method: Study sample comprised 194 nongeriatric adults who were seen in a general outpatient neuropsychology clinic for a variety of referral questions. The cognition subscale score from the WHO Disability Assessment Schedule served as the measure of perceived cognitive impairment. Objective cognitive performance was indexed via a composite score derived from a comprehensive neuropsychological battery. Internalizing psychopathology was indexed via a composite score derived from anxiety and depression measures. Medical and neuropsychiatric comorbidities were indexed by the number of different ICD diagnostic categories documented in medical records. Demographics included age, sex, race, and years of education. Results: Objective cognitive performance was unrelated to subjective concerns, explaining <1% of the variance in perceived cognitive impairment ratings. Conversely, internalizing psychopathology was significantly predictive, explaining nearly one-third of the variance in perceived cognitive impairment ratings, even after accounting for test performance, demographics, and number of comorbidities. Internalizing psychopathology was also highly associated with a greater discrepancy between scores on perceived and objective cognitive measures among participants with greater cognitive concerns. Clinically significant somatic symptoms uniquely contributed to the explained variance in perceived cognitive impairment (by ∼13%) when analyzed in a model with internalizing symptoms. Conclusions: These findings suggest that perceived cognitive impairment may be more indicative of the extent of internalizing psychopathology and somatic concerns than cognitive ability.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrea Cladek
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Michael Brook
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Morse RM, Lang I, Rapaport P, Poppe M, Morgan-Trimmer S, Cooper C. How might secondary dementia prevention programs work in practice: a pre-implementation study of the APPLE-Tree program. BMC Geriatr 2024; 24:188. [PMID: 38408902 PMCID: PMC10895907 DOI: 10.1186/s12877-024-04762-3] [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: 06/28/2023] [Accepted: 01/30/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Over 850,000 people in the UK currently have dementia, and that number is expected to grow rapidly. One approach that may help slow or prevent this growth is personalized dementia prevention. For most people, this will involve targeted lifestyle changes. These approaches have shown promise in trials, but as of yet, the evidence for how to scale them to a population level is lacking. In this pre-implementation study, we aimed to explore stakeholder perspectives on developing system-readiness for dementia prevention programs. We focused on the APPLE-Tree program, one of several low-intensity, lifestyle-based dementia prevention interventions currently in clinical trials. METHODS We conducted semi-structured interviews with health and social care professionals without previous experience with the APPLE-Tree program, who had direct care or managerial experience in services for older adults with memory concerns, without a dementia diagnosis. We used the Consolidated Framework for Implementation Research to guide interviews and thematic analysis. RESULTS We interviewed 26 stakeholders: commissioners and service managers (n = 15) and frontline workers (n = 11) from eight NHS and 11 third sector organizations throughout England. We identified three main themes: (1) favorable beliefs in the effectiveness of dementia prevention programs in enhancing cognition and wellbeing and their potential to fill a service gap for people with memory concerns, (2) challenges related to funding and capacity to deliver such programs at organizations without staff capacity or higher prioritization of dementia services, and (3) modifications to delivery and guidance required for compatibility with organizations and patients. CONCLUSION This study highlights likely challenges in scale-up if we are to make personalized dementia prevention widely available. This will only be possible with increased funding of dementia prevention activities; integrated care systems, with their focus on prevention, may enable this. Scale-up of dementia prevention programs will also require clear outlines of their core and adaptable components to fit funding, patient, and facilitator needs.
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Affiliation(s)
- Rachel M Morse
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
| | - Iain Lang
- Department of Health and Community Sciences, University of Exeter Medical School , Exeter, UK
- UK National Institute for Health and Care Research (NIHR) Applied Research Collaboration South West Peninsula (NIHR PenARC), Exeter , UK
| | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
| | - Michaela Poppe
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Sarah Morgan-Trimmer
- Department of Health and Community Sciences, University of Exeter Medical School , Exeter, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Na S, Lee C, Ho S, Hong YJ, Jeong JH, Park KH, Kim S, Wang MJ, Choi SH, Han S, Kang SW, Kang S, Yang DW. A Longitudinal Study on Memory Enhancement in Subjective Cognitive Decline Patients: Clinical and Neuroimaging Perspectives. J Alzheimers Dis 2024; 97:193-204. [PMID: 38108349 DOI: 10.3233/jad-230667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) refers to the self-reported persistent cognitive decline despite normal objective testing, increasing the risk of dementia compared to cognitively normal individuals. OBJECTIVE This study aims to investigate the attributes of SCD patients who demonstrated memory function improvement. METHODS In this prospective study of SCD, a total of 120 subjects were enrolled as part of a multicenter cohort study aimed at identifying predictors for the clinical progression to mild cognitive impairment or dementia (CoSCo study). All subjects underwent 18F-florbetaben PET and brain MRI scans at baseline and annual neuropsychological tests. At the 24-month follow-up, we classified SCD patients based on changes in memory function, the z-score of the Seoul verbal learning test delayed recall. RESULTS Of the 120 enrolled patients, 107 successfully completed the 24-month follow-up assessment. Among these, 80 patients (74.8%) with SCD exhibited memory function improvements. SCD patients with improved memory function had a lower prevalence of coronary artery disease at baseline and performed better in the trail-making test part B compared to those without improvement. Anatomical and biomarker analysis showed a lower frequency of amyloid PET positivity and larger volumes in the left and right superior parietal lobes in subjects with improved memory function. CONCLUSIONS Our prospective study indicates that SCD patients experiencing memory improvement over a 24-month period had a lower amyloid burden, fewer cardiovascular risk factors, and superior executive cognitive function. Identifying these key factors associated with cognitive improvement may assist clinicians in predicting future memory function improvements in SCD patients.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, South Korea
| | - Chonghwee Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - SeongHee Ho
- Department of Neurology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea
| | - Yun Jeong Hong
- Department of Neurology, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, South Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | | | - Seung Wan Kang
- Data Center for Korean EEG, College of Nursing, Seoul National University, Seoul, South Korea
- iMediSync Inc. Seoul, South Korea
| | - Sungmin Kang
- Research and Development, PeopleBio Inc., Seongnam-si, Gyeonggi-do, South Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
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Kann MR, Zeiger PJ, Rizer SJ, Cosentino S, Azar M. Virtual Assessment as a Way to Reduce Help-seeking Barriers in Older Adults With Subjective Cognitive Decline. Alzheimer Dis Assoc Disord 2023; 37:373-378. [PMID: 37738277 PMCID: PMC10719961 DOI: 10.1097/wad.0000000000000582] [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: 04/17/2023] [Accepted: 08/04/2023] [Indexed: 09/24/2023]
Abstract
Subjective cognitive decline (SCD), a potential early marker for neurodegenerative disease such as Alzheimer's disease, is common among older adults. Although it is often regarded as a personal health concern, most individuals with SCD do not seek help from a health care professional. Help-seeking (HS) is a complex, individualized process with significant life-course implications, and older adults often face several barriers to HS across personal, socioeconomic, and cultural domains. The pandemic exacerbated these barriers by imposing additional limitations on in-person care. In response, virtual assessment became a popular method to conduct remote care. We provide a narrative review of the challenges and triumphs that came with the transition from in-person, pen-paper cognitive assessments to virtual cognitive assessments. In addition, we address the impact virtual assessment had in tackling barriers that previously limited individuals with SCD from formal HS. We argue that virtual cognitive assessment helps alleviate health access barriers to HS (e.g., cost, transportation, and physician availability) and allows individuals with different coping styles to undergo assessment within more convenient environments. We hope the findings presented in this review inform health care practice, public education, and future research targeted towards the use of virtual assessment to facilitate HS in older adults with SCD.
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Affiliation(s)
- Michael R Kann
- Cognitive Neuroscience Division, Department of Neurology, G.H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center
| | - Peter J Zeiger
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Sandra J Rizer
- Cognitive Neuroscience Division, Department of Neurology, G.H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center
| | - Stephanie Cosentino
- Cognitive Neuroscience Division, Department of Neurology, G.H. Sergievsky Center, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center
| | - Martina Azar
- Psychology Department, VA Boston Health Care System, Boston, MA
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Azar M, Chapman S, Joyce J, Schultheis M, Zhang Z, Waltrip L, Shagalow S, Zeiger P, Sunderaraman P, Cosentino S. Education as a Moderator of Help Seeking Behavior in Subjective Cognitive Decline. Alzheimer Dis Assoc Disord 2023; 37:184-188. [PMID: 37561937 PMCID: PMC10530107 DOI: 10.1097/wad.0000000000000571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Disparities in Alzheimer disease (AD) and differences in help seeking (HS) across sociodemographic groups warrant public health concern. Research addressing such disparities must shift toward the earliest clinical manifestations of AD to optimize diagnosis, intervention and care planning. Subjective cognitive decline (SCD), a risk state for AD, provides an important context in which to examine sociodemographic-related disparities in HS. PARTICIPANTS AND METHODS One hundred sixty-seven cognitively healthy older adults (M age =73, M education =16) (26.4% Black, Asian, or "Other") completed SCD questionnaire, HS questions, and mood measures (depression and anxiety). Binary logistic adjusted regressions examined: (a) the association between SCD and HS; and (b) the extent to which education moderated the relationship between SCD and HS. SCD [b = 0.06, SE=0.13, P <0.001, odds ratio=1.06, 95% CI (1.03, 1.08)] and education [b=0.32, SE=0.09, P <0.001, odds ratio=1.37, 95% CI (1.15, 1.64)] were independently associated with HS, with significant interaction between education and SCD on HS [b=0.2, SE=0.01, P =0.01, odds ratio=1.02, 95% CI (1.00, 1.03)]. CONCLUSIONS Findings elucidate the importance of tailoring SCD-related psychoeducational resources depending on educational background as a preliminary stepping-stone in encouraging HS among older adults who may be at particular risk for developing dementia.
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Affiliation(s)
- Martina Azar
- Psychology Department, VA Boston Healthcare System, Boston, MA, USA
| | - Silvia Chapman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Jillian Joyce
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Maria Schultheis
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Zoe Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Leah Waltrip
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Shaina Shagalow
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
| | - Peter Zeiger
- Vagelos College of Physicians and Surgeons, Columbia University, NY, NY, USA
| | | | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, NY, NY, USA
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Lee CD, Foster ER. Subjective Memory Complaints Predict Decline in Memory, Instrumental Activities of Daily Living, and Social Participation in Older Adults: A Fixed-Effects Model. Am J Occup Ther 2023; 77:7704205100. [PMID: 37606938 PMCID: PMC10494969 DOI: 10.5014/ajot.2023.050151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Abstract
IMPORTANCE Although subjective memory complaints (SMCs) have been suggested to be associated with future memory impairment, limitations in instrumental activities of daily living (IADLs), and social participation restriction, these associations are still inconclusive. OBJECTIVE To determine whether changes in SMCs over time predict decline in memory, IADLs, and social participation in older adults. DESIGN Longitudinal study. SETTING Community. PARTICIPANTS Sample 1 included 2,493 community-dwelling older adults drawn from the Health and Retirement Study (HRS) data collected between 2004 and 2018. Sample 2 included 1,644 community-dwelling older adults drawn from the HRS data collected between 2008 and 2018. OUTCOMES AND MEASURES Self-reported SMCs, memory function, self-reported IADL performance, and self-reported social participation. RESULTS The mean age of Sample 1 at baseline was 70.16 yr; 1,468 (58.88%) were female. In Sample 1, immediate and delayed memory (all ps < .001) and IADL performance (p < .01) declined over time. Increases in SMCs over time significantly predicted future immediate and delayed memory declines (p < .01 and p < .001, respectively) and future IADL performance decline (p < .001), after controlling for depressive symptoms. The mean age of Sample 2 at baseline was 71.52 yr; 928 (56.45%) were female. In Sample 2, social participation declined over time (all ps < .001). Increases in SMCs over time significantly predicted future social participation decline (p < .05), after controlling for depressive symptoms. CONCLUSIONS AND RELEVANCE Increases in SMCs predict future decline in memory, IADL performance, and social participation after accounting for depressive symptoms. What This Article Adds: SMCs can be used as an early indicator of future memory impairment, IADL limitations, and social participation restrictions in older adults. Furthermore, interventions that minimize SMCs may help older adults achieve successful aging.
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Affiliation(s)
- Chang Dae Lee
- Chang Dae Lee, PhD, OTR/L, is Postdoctoral Researcher, Human Engineering Research Laboratories, Department of Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, and Human Engineering Research Laboratories, Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA;
| | - Erin R Foster
- Erin R. Foster, PhD, OTD, OTR/L, is Associate Professor, Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO
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Lazarou I, Oikonomou VP, Mpaltadoros L, Grammatikopoulou M, Alepopoulos V, Stavropoulos TG, Bezerianos A, Nikolopoulos S, Kompatsiaris I, Tsolaki M. Eliciting brain waves of people with cognitive impairment during meditation exercises using portable electroencephalography in a smart-home environment: a pilot study. Front Aging Neurosci 2023; 15:1167410. [PMID: 37388185 PMCID: PMC10306118 DOI: 10.3389/fnagi.2023.1167410] [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: 02/16/2023] [Accepted: 05/03/2023] [Indexed: 07/01/2023] Open
Abstract
Objectives Meditation imparts relaxation and constitutes an important non-pharmacological intervention for people with cognitive impairment. Moreover, EEG has been widely used as a tool for detecting brain changes even at the early stages of Alzheimer's Disease (AD). The current study investigates the effect of meditation practices on the human brain across the AD spectrum by using a novel portable EEG headband in a smart-home environment. Methods Forty (40) people (13 Healthy Controls-HC, 14 with Subjective Cognitive Decline-SCD and 13 with Mild Cognitive Impairment-MCI) participated practicing Mindfulness Based Stress Reduction (Session 2-MBSR) and a novel adaptation of the Kirtan Kriya meditation to the Greek culture setting (Session 3-KK), while a Resting State (RS) condition was undertaken at baseline and follow-up (Session 1-RS Baseline and Session 4-RS Follow-Up). The signals were recorded by using the Muse EEG device and brain waves were computed (alpha, theta, gamma, and beta). Results Analysis was conducted on four-electrodes (AF7, AF8, TP9, and TP10). Statistical analysis included the Kruskal-Wallis (KW) nonparametric analysis of variance. The results revealed that both states of MBSR and KK lead to a marked difference in the brain's activation patterns across people at different cognitive states. Wilcoxon Signed-ranks test indicated for HC that theta waves at TP9, TP10 and AF7, AF8 in Session 3-KK were statistically significantly reduced compared to Session 1-RS Z = -2.271, p = 0.023, Z = -3.110, p = 0.002 and Z = -2.341, p = 0.019, Z = -2.132, p = 0.033, respectively. Conclusion The results showed the potential of the parameters used between the various groups (HC, SCD, and MCI) as well as between the two meditation sessions (MBSR and KK) in discriminating early cognitive decline and brain alterations in a smart-home environment without medical support.
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Affiliation(s)
- Ioulietta Lazarou
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Vangelis P. Oikonomou
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Lampros Mpaltadoros
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Margarita Grammatikopoulou
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Vasilis Alepopoulos
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Thanos G. Stavropoulos
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Anastasios Bezerianos
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Spiros Nikolopoulos
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
| | - Magda Tsolaki
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute (ITI), Thessaloniki, Greece
- 1st Department of Neurology, Faculty of Health Sciences, G.H. “AHEPA”, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI–AUTh), Aristotle University of Thessaloniki, Thessaloniki, Greece
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Gómez-Soria I, Cuenca-Zaldívar JN, Rodriguez-Roca B, Subirón-Valera AB, Salavera C, Marcén-Román Y, Andrade-Gómez E, Calatayud E. Cognitive Effects of a Cognitive Stimulation Programme on Trained Domains in Older Adults with Subjective Memory Complaints: Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3636. [PMID: 36834329 PMCID: PMC9967658 DOI: 10.3390/ijerph20043636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Age-related subjective memory complaints (SMC) are a common concern among older adults. However, little is known about the effects of cognitive stimulation (CS) interventions on subjective memory complaints. The aim of this study was to analyse the effectiveness of a CS programme on global cognition and cognitive functions of older adults with SMC. A randomised clinical trial was conducted on older adults with SMC, including 308 participants ≥65 years of age assessed 6 and 12 months after the intervention. The assessment instrument was the Spanish version of the Mini-Mental State Examination (MEC-35), and all domains of the instrument were assessed. For statistical analysis, the data were analysed using robust ANOVA with means truncated at 20% utilising a two-way repeated measures model, with between (groups) and within (measurements) factors. In post hoc tests, a Wilcoxon signed-rank test of exact permutations between groups and Bonferroni correction were applied. In post hoc between-group tests, significant differences were found: (1) post-treatment in MEC-35, temporal orientation, short-term memory (STM), global language and praxis, and language and praxis (p ≤ 0.005); (2) at 6 months in MEC-35, global orientation, temporal orientation, and STM (p = 0.005); (3) at 12 months in MEC-35, global orientation, temporal orientation, STM, global language and praxis, and language (p = 0.005). This study shows benefits in global cognition and orientation, temporal orientation, STM, and language in older adults with SMC.
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Affiliation(s)
- Isabel Gómez-Soria
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Health Research Institute of Aragon, 50009 Zaragoza, Spain
| | - Juan Nicolás Cuenca-Zaldívar
- Grupo de Investigación en Fisioterapia y Dolor, Departamento de Enfermería y Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain
- Physical Therapy Unit, Primary Health Care Center “El Abajón”, Las Rozas de Madrid, 28231 Madrid, Spain
| | | | | | - Carlos Salavera
- Department of Psychology and Sociology, Education Faculty, University of Zaragoza, 50009 Zaragoza, Spain
| | - Yolanda Marcén-Román
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Health Research Institute of Aragon, 50009 Zaragoza, Spain
| | - Elena Andrade-Gómez
- Department of Nursing, University of La Rioja, La Rioja, 26004 Logroño, Spain
| | - Estela Calatayud
- Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Health Research Institute of Aragon, 50009 Zaragoza, Spain
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11
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Moret-Tatay C, Zharova I, Iborra-Marmolejo I, Bernabé-Valero G, Jorques-Infante MJ, Beneyto-Arrojo MJ. Psychometric Properties of the Subjective Cognitive Decline Questionnaire (SCD-Q) and Its Invariance across Age Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1220. [PMID: 36673996 PMCID: PMC9859323 DOI: 10.3390/ijerph20021220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Considering that a good sense of subjective cognitive decline seems to be crucial to prevent decline before clinical impairment, the interest in examining tools on this front were raised in the last decade. The aim of the present study is to examine the psychometric properties of the Subjective Cognitive Decline Questionnaire (SCD-Q) across age in its Spanish adaptation. It should be noted that two constructs were proposed in this context: mnestic processes and executive function factors. For this reason, a sample of 750 individuals aged from 18 to 82 years participated in the study. They were divided into three different groups: young, middle, and older adults. A confirmatory factor analysis (CFA) and invariance analysis were carried out. Moreover, a logistic regression was employed to address the role of age. The results support a good goodness of fit for both uni- and bifactorial models. The invariance analysis reached the structural covariances levels. Last, age did not predict the recognition of cognitive decline in the last two years, while the SCD-Q bifactorial model did. These results are of interest both on a theoretical level, to provide more information on models of cognitive impairment, and on a practical level, for screening.
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Affiliation(s)
- Carmen Moret-Tatay
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - Iryna Zharova
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
- Faculty of Psychology, National University of Ukraine on Physical Education and Sport, Kiev. Ukraine. St. Fizkul’tury, 1, 0315 Kyiv, Ukraine
| | - Isabel Iborra-Marmolejo
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - Gloria Bernabé-Valero
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - María José Jorques-Infante
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - María José Beneyto-Arrojo
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
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12
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A Cost-Benefit Analysis of a Group Memory Intervention for Healthy Older Adults with Memory Concerns. Can J Aging 2022; 41:531-539. [PMID: 35726601 DOI: 10.1017/s0714980821000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study examines whether memory intervention programs can mitigate health care costs. Research suggests these programs translate to a decreased intention of older adults who are worried about age-normal memory changes to seek traditional outlets for medical/psychiatric help. We employed a cost-benefit analysis approach to analyze the effectiveness of a memory intervention program within Ontario. We leveraged estimates of decreased intentionality to seek physician care following a community-based memory intervention with physician billing profiles to calculate the potential cost savings to the province's health care system. The intervention studied was found to reduce provincial health care spending by $6,094 per program group. This amount exceeds $121.25 in direct costs per attendee associated with administering five program sessions. This analysis justifies further research on how community-based memory and aging programs can offer low-cost solutions to help individuals cope with subjective memory complaints and assist the health care system in prioritizing care for aging patients.
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13
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Janssen O, Jansen WJ, Vos SJ, Boada M, Parnetti L, Gabryelewicz T, Fladby T, Molinuevo JL, Villeneuve S, Hort J, Epelbaum S, Lleó A, Engelborghs S, van der Flier WM, Landau S, Popp J, Wallin A, Scheltens P, Rikkert MO, Snyder PJ, Rowe C, Chételat G, Ruíz A, Marquié M, Chipi E, Wolfsgruber S, Heneka M, Boecker H, Peters O, Jarholm J, Rami L, Tort‐Merino A, Binette AP, Poirier J, Rosa‐Neto P, Cerman J, Dubois B, Teichmann M, Alcolea D, Fortea J, Sánchez‐Saudinós MB, Ebenau J, Pocnet C, Eckerström M, Thompson L, Villemagne V, Buckley R, Burnham S, Delarue M, Freund‐Levi Y, Wallin ÅK, Ramakers I, Tsolaki M, Soininen H, Hampel H, Spiru L, Tijms B, Ossenkoppele R, Verhey FRJ, Jessen F, Visser PJ. Characteristics of subjective cognitive decline associated with amyloid positivity. Alzheimers Dement 2022; 18:1832-1845. [PMID: 34877782 PMCID: PMC9786747 DOI: 10.1002/alz.12512] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/21/2021] [Accepted: 09/22/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The evidence for characteristics of persons with subjective cognitive decline (SCD) associated with amyloid positivity is limited. METHODS In 1640 persons with SCD from 20 Amyloid Biomarker Study cohort, we investigated the associations of SCD-specific characteristics (informant confirmation, domain-specific complaints, concerns, feelings of worse performance) demographics, setting, apolipoprotein E gene (APOE) ε4 carriership, and neuropsychiatric symptoms with amyloid positivity. RESULTS Between cohorts, amyloid positivity in 70-year-olds varied from 10% to 76%. Only older age, clinical setting, and APOE ε4 carriership showed univariate associations with increased amyloid positivity. After adjusting for these, lower education was also associated with increased amyloid positivity. Only within a research setting, informant-confirmed complaints, memory complaints, attention/concentration complaints, and no depressive symptoms were associated with increased amyloid positivity. Feelings of worse performance were associated with less amyloid positivity at younger ages and more at older ages. DISCUSSION Next to age, setting, and APOE ε4 carriership, SCD-specific characteristics may facilitate the identification of amyloid-positive individuals.
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Affiliation(s)
- Olin Janssen
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Willemijn J. Jansen
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Stephanie J.B. Vos
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Merce Boada
- Fundació ACEInstitut Català de Neurociències AplicadesFacultat de MedicinaUniversitat International de Catalunya‐BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
| | - Lucilla Parnetti
- Section of NeurologyCenter for Memory Disturbances – Lab. of Clinical NeurochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative DisordersMossakowski Medical Research CentrePolish Academy of SciencesWarsawPoland
| | - Tormod Fladby
- Department of NeurologyAkershus University HospitalLorenskogNorway
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Sylvia Villeneuve
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Jakub Hort
- Department of NeurologySecond Faculty of MedicineCharles University and Motol University HospitalPragueCzech Republic,International Clinical Research CenterSt. Anne's University HospitalBrnoCzech Republic
| | - Stéphane Epelbaum
- AP‐HPHôpital de la Pitié SalpêtrièreInstitute of Memory and Alzheimer's Disease (IM2A)Centre of excellence of neurodegenerative disease (CoEN)Department of NeurologyParisFrance,Inserm Sorbonne UniversitéInriaAramis project‐teamParis Brain Institute – Institut du Cerveau (ICM)ParisFrance
| | - Alberto Lleó
- Neurology DepartmentHospital de Sant PauBarcelonaSpain
| | | | - Wiesje M. van der Flier
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Susan Landau
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeley, CaliforniaUSA
| | - Julius Popp
- Department of Geriatric PsychiatryPsychiatric University Hospital, ZürichSwitzerland,Old Age PsychiatryUniversity Hospital of LausanneLausanneSwitzerland
| | - Anders Wallin
- CSIRO Health & BiosecurityParkvilleVictoriaAustralia,Institute of Neuroscience and PhysiologySahlgrenska Academy at University of GothenburgMölndalSweden
| | - Philip Scheltens
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Marcel Olde Rikkert
- Department of Geriatric MedicineRadboud Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Peter J. Snyder
- Institute of Clinical MedicineUniversity of OsloOsloNorway,KingstonThe University of Rhode IslandRhode IslandUSA
| | - Chris Rowe
- Department of Molecular Imaging & TherapyAustin HealthMelbourneAustralia
| | - Gaël Chételat
- Institut National de la Sant. et de la Recherche M.dicale (Inserm)CaenFrance
| | - Agustin Ruíz
- Fundació ACEInstitut Català de Neurociències AplicadesFacultat de MedicinaUniversitat International de Catalunya‐BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
| | - Marta Marquié
- Fundació ACEInstitut Català de Neurociències AplicadesFacultat de MedicinaUniversitat International de Catalunya‐BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
| | - Elena Chipi
- Section of NeurologyCenter for Memory Disturbances – Lab. of Clinical NeurochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Steffen Wolfsgruber
- German Center For Neurodegenerative Diseases/Clinical ResearchDeutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)Zentrum für klinische Forschung/AGCologneGermany,Department of Neurodegenerative Diseases and PsychiatryUniversity Hospital BonnBonnGermany
| | - Michael Heneka
- Department of Neurodegenerative Diseases and PsychiatryUniversity Hospital BonnBonnGermany
| | - Henning Boecker
- Functional Neuroimaging GroupDepartment of RadiologyUniversity Hospital BonnBonnGermany
| | - Oliver Peters
- Klinik für Psychiatrie und PsychotherapieCharité Universitätsmedizin Berlin ‐ CBFBerlinDeutschland
| | - Jonas Jarholm
- Department of NeurologyAkershus University HospitalLorenskogNorway
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Adrià Tort‐Merino
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Alexa Pichet Binette
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Judes Poirier
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Pedro Rosa‐Neto
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Jiri Cerman
- Department of NeurologySecond Faculty of MedicineCharles University and Motol University HospitalPragueCzech Republic,International Clinical Research CenterSt. Anne's University HospitalBrnoCzech Republic
| | - Bruno Dubois
- AP‐HPHôpital de la Pitié SalpêtrièreInstitute of Memory and Alzheimer's Disease (IM2A)Centre of excellence of neurodegenerative disease (CoEN)Department of NeurologyParisFrance
| | - Marc Teichmann
- AP‐HPHôpital de la Pitié SalpêtrièreInstitute of Memory and Alzheimer's Disease (IM2A)Centre of excellence of neurodegenerative disease (CoEN)Department of NeurologyParisFrance
| | | | - Juan Fortea
- Neurology DepartmentHospital de Sant PauBarcelonaSpain
| | | | - Jarith Ebenau
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Cornelia Pocnet
- Old Age PsychiatryUniversity Hospital of LausanneLausanneSwitzerland
| | - Marie Eckerström
- Institute of Neuroscience and PhysiologySahlgrenska Academy at University of GothenburgMölndalSweden
| | - Louisa Thompson
- Institute of Clinical MedicineUniversity of OsloOsloNorway,KingstonThe University of Rhode IslandRhode IslandUSA
| | - Victor Villemagne
- Department of Molecular Imaging & TherapyAustin HealthMelbourneAustralia,Department of PsychiatryUniversity of PittsburghPittsburghUSA
| | - Rachel Buckley
- Brigham and Women's Hospital and Department of Neurology Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Samantha Burnham
- Section of NeurologyCenter for Memory Disturbances – Lab. of Clinical NeurochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Marion Delarue
- Institut National de la Sant. et de la Recherche M.dicale (Inserm)CaenFrance
| | - Yvonne Freund‐Levi
- Department of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Åsa K. Wallin
- Department of Clinical Sciences MalmöClinical Memory Research UnitLund UniversityLundSweden
| | - Inez Ramakers
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Magda Tsolaki
- Memory and Dementia Center3rd Department of Neurology“G Papanicolau” General HospitalAristotle University of ThessalonikiThessalonikiGreece
| | - Hilkka Soininen
- Institute of Clinical MedicineNeurologyUniversity of Eastern FinlandKuopioFinland
| | - Harald Hampel
- GRC no 21, Alzheimer Precision Medicine (AMP)AP‐HPPitié‐Salpêtrière HospitalSorbonne UniversityParisFrance
| | - Luiza Spiru
- Carol DAVILA University of Medicine and PharmacyBucharestRomania,Geriatrics‐ Gerontology and Old Age PsychiatryAlzheimer UnitAna Aslan International Foundation – Memory Center and Longevity MedicineBucharestRomania
| | | | | | | | - Betty Tijms
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands,Clinical Memory Research UnitDepartment of Clinical SciencesMalmöLund UniversityLundSweden,Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Frans R. J. Verhey
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Frank Jessen
- Department of PsychiatryUniversity of CologneCologneGermany,German Center For Neurodegenerative Diseases/Clinical ResearchDeutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)Zentrum für klinische Forschung/AGCologneGermany
| | - Pieter Jelle Visser
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands,Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands,Department of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
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Yin S, Xiong J, Zhu X, Li R, Li J. Cognitive training modified age-related brain changes in older adults with subjective memory decline. Aging Ment Health 2022; 26:1997-2005. [PMID: 34498987 DOI: 10.1080/13607863.2021.1972931] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Neuroimaging findings suggest that older adults with subjective memory decline (SMD) demonstrate some neurodegenerative brain changes and have high risk of developing dementia, but relatively little is known about the effectiveness of interventions for SMD. This study aimed to examine the effects of cognitive training on resting-state brain activity in SMD. METHOD This study employed the amplitude of low frequency fluctuations (ALFF) and resting state functional connectivity (rs-FC) analyses. After baseline evaluations, participants were randomly allocated to the intervention and control group to receive a four-week cognitive training and lectures on health and aging, respectively. All participants were scanned before and after training with an interval of about three months. RESULTS (1) Participants in the intervention group showed significant improvements on the Associative Learning Test (ALT) and the Digit Span Forward task compared to the control group; (2) ALFF in the occipital lobe for the control group increased significantly, while that for the intervention group remained the same; ALFF changes were negatively correlated with ALT performance in the control group; (3) The mean value of rs-FC for the intervention group decreased, while that for the control group showed a trend of increase; rs-FC changes were also negatively correlated with ALT performance in the control group. CONCLUSIONS Resting-state brain activities in occipital region increased with aging. The cognitive training could counteract this brain function changes associated with aging or even reverse the changes. These findings provide new insights into the understanding of brain plasticity in posterior areas in SMD. TRIAL REGISTRATION ChiCTR-IOR-15006165 in the Chinese Clinical Trial Registry.
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Affiliation(s)
- Shufei Yin
- Department of Psychology, Faculty of Education, Hubei University, Wuhan, China.,Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jinli Xiong
- Department of Psychology, Faculty of Education, Hubei University, Wuhan, China
| | - Xinyi Zhu
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rui Li
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Juan Li
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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15
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Comparison of the Greek Version of the Quick Mild Cognitive Impairment Screen and Montreal Cognitive Assessment in Older Adults. Healthcare (Basel) 2022; 10:healthcare10050906. [PMID: 35628043 PMCID: PMC9141789 DOI: 10.3390/healthcare10050906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: Cognitive screening instruments (CSIs) are essential for everyday practice. The Quick Mild Cognitive Impairment (Qmci) screen, a short instrument designed to identify mild cognitive impairment, was recently translated into Greek (Qmci-Gr). The present study compared its diagnostic value against the Montreal Cognitive Assessment (MoCA) screen and examined its optimal cutoffs. Method: We recruited consecutive patients aged ≥55 years that presented with cognitive complaints from two outpatient clinics in Greece. The Qmci-Gr and MoCA were completed by all patients. Furthermore, they were assessed independently with a comprehensive flexible neuropsychological battery to establish a diagnostic classification. Results: In the current study, we assessed a total of 145 patients, with a median age of 70 years; 44 were classified as having Subjective Memory Complaints (SMC) but normal cognition, 32 with MCI and 69 with dementia. The Qmci-Gr had a higher accuracy compared to the MoCA in discriminating MCI from dementia, area under the curve (AUC) of 0.81 versus 0.75, respectively; however, this finding was marginally significant (p = 0.08). Its accuracy was marginally higher for distinguishing SMC from dementia, AUC of 0.94 versus 0.89 (p = 0.03). However, Qmci-Gr presented a lower accuracy than MoCa in differentiating SMC from MCI, AUC of 0.76 versus 0.94 (p = 0.006). Conclusions: The Qmci-Gr has comparable diagnostic accuracy to the MoCA regarding MCI and dementia groups. Further research, with larger and more diverse samples, may be necessary to ensure generalizability.
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16
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Ross SD, Hofbauer LM, Rodriguez FS. Coping strategies for memory problems in everyday life of people with cognitive impairment and older adults: A systematic review. Int J Geriatr Psychiatry 2022; 37. [PMID: 35362220 DOI: 10.1002/gps.5701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Dealing with memory loss is a major challenge for older people. Coping strategies for memory problems could enable cognitively impaired people to live independently for longer. We conducted a systematic review to summarize evidence on coping strategies for older people and people with cognitive impairment to stabilize everyday life functioning. METHODS We systematically searched the databases PubMed, PsychInfo, Scopus and WebofScience using a well-defined search string. Studies were included if they were published between January 1990 and February 2021 and written in English, German, Spanish, French, or Swedish language. Two blind researchers independently checked the studies for inclusion and exclusion criteria and evaluated the quality of the studies using Critical Appraisal Skills Programme-checklists. Evidence was summarized in a narrative synthesis. RESULTS A total of 16 relevant studies with adequate quality were identified. These studies reported on three categories of strategies: external, internal, and behavioral coping strategies. External strategies included reminder systems and integrated features in the environment and were used by people with and without cognitive impairments. Internal strategies such as visualization, verbalization, active remembering, and systematic thinking were reported less often by people with cognitive impairment than those without cognitive impairment. Behavioral strategies such as reducing expectations and acceptance of support was most frequently reported by people with cognitive impairment. CONCLUSIONS The findings of our systematic review show a great number of coping strategies, which seem to depend on cognitive status. Appropriate training tools incorporating these strategies should be developed.
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Affiliation(s)
- Sabrina D Ross
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology & Public Health, Greifswald, Germany
| | - Lena M Hofbauer
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology & Public Health, Greifswald, Germany
| | - Francisca S Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology & Public Health, Greifswald, Germany
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17
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Mace RA, Popok PJ, Hopkins SW, Fishbein NS, Vranceanu AM. Adaptation and virtual feasibility pilot of a mindfulness-based lifestyle program targeting modifiable dementia risk factors in older adults. Aging Ment Health 2022; 27:695-707. [PMID: 35100922 DOI: 10.1080/13607863.2022.2032600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES We developed a group-based program (My Healthy Brain, MHB) to engage older adults at-risk for dementia in healthy lifestyles. We report on a two-part study to adapt MHB by incorporating mindfulness skills, using mobile health technology to monitor and reinforce behaviors, and delivering it via live video. METHODS Participants were older adults (age ≥ 60) with subjective cognitive decline (SCD) and at least one lifestyle risk factor. In Aim 1 (n = 11, 2 groups), we conducted focus groups to obtain qualitative feedback on proposed adaptations. In Aim 2 (n = 10), we conducted a virtual open pilot with exit interviews to explore the feasibility and outcomes of the adapted MHB. RESULTS Thematic analysis revealed: (1) barriers and facilitators to healthy lifestyles, (2) positive impressions of MHB, (3) interest in mindfulness skills, and (4) openness to study technologies. MHB met a-priori feasibility benchmarks and was associated with improvements in cognition, lifestyle (e.g. physical function), and proposed mechanisms (e.g. mindfulness). Exit interviews confirmed high feasibility and satisfaction. CONCLUSION The integration of mindfulness, live video, and mobile health technologies was feasible and promising for improving healthier lifestyles. The results inform the next feasibility RCT of MHB to prepare for efficacy testing. UNLABELLED Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2032600.
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Affiliation(s)
- Ryan A Mace
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Paula J Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah W Hopkins
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Nathan S Fishbein
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Shim YS, Shin HE. Impact of the ambulatory blood pressure monitoring profile on cognitive and imaging findings of cerebral small-vessel disease in older adults with cognitive complaints. J Hum Hypertens 2022; 36:14-23. [PMID: 33589760 PMCID: PMC8766279 DOI: 10.1038/s41371-021-00490-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 12/21/2020] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
Abstract
We investigated ambulatory blood pressure (BP) monitoring (ABPM) profiles and magnetic resonance imaging (MRI) findings of cerebral small-vessel disease (cSVD) in older adults with cognitive complaints who were grouped as follows: subjective cognitive decline, mild cognitive impairment, and dementia of Alzheimer's type. Group comparisons and correlation analyses among demographic characteristics, cognitive and MRI findings, and ABPM profiles were performed. Furthermore, multivariate logistic regression analyses for dependent variables of (1) dementia or not and (2) MRI criteria of subcortical vascular dementia (SVaD) or not were conducted with independent variables of dichotomized ABPM profiles. A total of 174 subjects (55 males and 119 females) were included: mean age 75.36 ± 7.13 years; Mini-Mental State Examination (MMSE) score 20.51 ± 6.23. No MRI and ABPM findings except medial temporal atrophy were different between three groups. Twenty-four-hour systolic BP (sBP) was correlated with MMSE score (r = -0.182; p = 0.022) and the severity of white matter hyperintensity (WMH) (r = 0.157; p = 0.048). A higher daytime sBP was associated with dementia (odds ratio (OR): 3.734; 95% confidence interval (CI): 1.041-13.390; p = 0.043) and MRI finding of SVaD (OR: 10.543; 95% CI: 1.161-95.740; p = 0.036). Although there were no differences in ABPM profiles between three groups, a higher BP-especially a higher sBP-correlated with cognitive dysfunction and severity of WMH in older adults. Only higher daytime sBP was an independent predictor for dementia and MRI findings of SVaD. Among various ABPM profiles in this study, a higher BP, especially a higher sBP, may be considered the most important for clinical and MRI findings of cSVD.
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Affiliation(s)
- Yong S. Shim
- grid.411947.e0000 0004 0470 4224Department of Neurology, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Hae-Eun Shin
- grid.411947.e0000 0004 0470 4224Department of Neurology, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Bucheon, Korea
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19
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Clinical Application of Plasma Neurofilament Light Chain in a Memory Clinic: A Pilot Study. Dement Neurocogn Disord 2022; 21:59-70. [PMID: 35585907 PMCID: PMC9085534 DOI: 10.12779/dnd.2022.21.2.59] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose Neurofilament light chain (NfL) has been considered as a biomarker for neurodegenerative diseases including Alzheimer’s disease (AD). We measured plasma NfL levels in older adults with cognitive complaints and evaluated their clinical usefulness in AD. Methods Plasma levels of NfL, measured by using the single molecule array method, were acquired in a total of 113 subjects consisting of subjective cognitive decline (SCD; n=14), mild cognitive impairment (MCI; n=37), or dementia of Alzheimer type (DAT; n=62). Plasma NfL level was compared among three groups, and its association with cognitive and functional status was also analyzed. Results After adjusting for age, plasma NfL level was higher in subjects with DAT (65.98±84.96 pg/mL), compared to in subjects with SCD (16.90±2.54 pg/mL) or MCI (25.53±10.42 pg/mL, p=0.004). NfL levels were correlated with scores of the mini-mental state examination (r=−0.242, p=0.021), clinical dementia rating (CDR) (r=0.291, p=0.005), or CDR-sum of boxes (r=0.276, p=0.008). Just for participants who performed amyloid positron emission tomography (PET), the levels were different between subjects with PET (−) (n=17, 25.95±13.25 pg/mL) and PET (+) (n=16, 63.65±81.90 pg/mL, p=0.010). Additionally, plasma NfL levels were different between vascular dementia and vascular MCI, and between Parkinson’s disease- dementia and no dementia. Conclusions This pilot study shows that in subjects with DAT, plasma NfL levels increase. Plasma NfL level correlated with cognitive and functional status. Further longitudinal studies may help to apply the plasma NfL levels to AD, as a potential biomarker for the diagnosis and predicting progression.
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20
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Hallam B, Rees J, Petersen I, Cooper C, Avgerinou C, Walters K. How are people with mild cognitive impairment or subjective memory complaints managed in primary care? A systematic review. Fam Pract 2021; 38:669-683. [PMID: 33907811 PMCID: PMC8604277 DOI: 10.1093/fampra/cmab014] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Primary care is typically the first point of contact in the health care system for people raising concerns about their memory. However, there is still a lack of high-quality evidence and understanding about how primary care professionals (PCPs) currently manage people at higher risk of developing dementia. OBJECTIVES To systematically review management strategies provided by PCPs to reduce cognitive decline in people with mild cognitive impairment and subjective memory complaints. METHOD A systematic search for studies was conducted in December 2019 across five databases (EMBASE, Medline, PsycInfo, CINAHL and Web of Science). Methodological quality of included studies was independently assessed by two authors using the Mixed Methods Appraisal Tool. RESULTS An initial 11 719 were found, 7250 were screened and 9 studies were included in the review. Most studies were self-reported behaviour surveys. For non-pharmacological strategies, the most frequent advice PCPs provided was to increase physical activity, cognitive stimulation, diet and social stimulation. For pharmacological strategies, PCPs would most frequently not prescribe any treatment. If PCPs did prescribe, the most frequent prescriptions targeted vascular risk factors to reduce the risk of further cognitive decline. CONCLUSION PCPs reported that they are much more likely to provide non-pharmacological strategies than pharmacological strategies in line with guidelines on preventing the onset of dementia. However, the quality of evidence within the included studies is low and relies on subjective self-reported behaviours. Observational research is needed to provide an accurate reflection of how people with memory problems are managed in primary care.
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Affiliation(s)
- Brendan Hallam
- UCL Research Department of Primary Care and Population Health, London, UK
| | - Jessica Rees
- Division of Psychiatry, University College London, London, UK
| | - Irene Petersen
- UCL Research Department of Primary Care and Population Health, London, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK
| | | | - Kate Walters
- UCL Research Department of Primary Care and Population Health, London, UK
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21
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Goldberg SM, Lopez OL, Cohen AD, Klunk WE, Aizenstein HA, Mizuno A, Snitz BE. The roles of study setting, response bias, and personality in subjective memory complaints of cognitively normal older adults. Int Psychogeriatr 2021; 33:665-676. [PMID: 32188533 PMCID: PMC7501183 DOI: 10.1017/s1041610220000319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This study investigated subjective memory complaints in older adults and the roles of setting, response bias, and personality. DESIGN Cognitively normal older adults from two settings completed questionnaires measuring memory complaints, response bias, and personality. SETTINGS (A) Neuroimaging study with community-based recruitment and (B) academic memory clinic. PARTICIPANTS Cognitively normal older adults who (A) volunteer for research (N = 92) or (B) self-referred to a memory clinic (N = 20). MEASUREMENTS Neuropsychological evaluation and adjudication of normal cognitive status were done by the neuroimaging study or memory clinic. This study administered self-reports of subjective memory complaints, response bias, five-factor personality, and depressive symptoms. Primary group differences were examined with secondary sensitivity analyses to control for sex, age, and education differences. RESULTS There was no significant difference in over-reporting response bias between study settings. Under-reporting response bias was higher in volunteers. Cognitive complaints were associated with response bias for two cognitive complaint measures. Neuroticism was positively associated with over-reporting in evaluation-seekers and negatively associated with under-reporting in volunteers. The relationship was reversed for Extraversion. Under-reporting bias was positively correlated with Agreeableness and Conscientiousness in volunteers. CONCLUSION Evaluation-seekers do not show bias toward over-reporting symptoms compared to volunteers. Under-reporting response bias may be important to consider when screening for memory impairment in non-help-seeking settings. The Memory Functioning Questionnaire was less sensitive to reporting biases. Over-reporting may be a facet of higher Neuroticism. Findings help elucidate psychological influences on self-perceived cognitive decline and help seeking in aging and may inform different strategies for assessment by setting.
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Affiliation(s)
- Sarah M. Goldberg
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Oscar L. Lopez
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Ann D. Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - William E. Klunk
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Howard A. Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Akiko Mizuno
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Beth E. Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
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22
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Rotenberg S, Leung C, Quach H, Anderson ND, Dawson DR. Occupational performance issues in older adults with subjective cognitive decline. Disabil Rehabil 2021; 44:4681-4688. [PMID: 33989108 DOI: 10.1080/09638288.2021.1916626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To describe and categorize difficulties in daily activities of older adults with subjective cognitive decline (SCD) compared to individuals with mild cognitive impairment (MCI). METHODS Deductive quantitative content analysis was used to classify reported issues in the performance of meaningful daily activities, in older adults with SCD (n = 67; age= 70 ± 6.3) or MCI (n = 42; age= 72 ± 6.6). The occupational performance issues were identified using the Canadian Occupational Performance Measure, a semi-structured interview, and categorised using the International Classification of Functioning, Disability and Health (ICF). RESULTS Both groups identified issues in all nine ICF "Activities and Participation" domains, with no significant group effects on seven of them. The most frequently affected "Activities and Participation" domains in both groups were "Self-care" (e.g. exercise and diet); "Community, social and civic life" (e.g. social-leisure activities); and "General tasks and demands" (e.g. time management). Over 90% of the issues in both groups were described in the context of difficulties in "Mental functions" (e.g. memory and higher-level cognitive functions). CONCLUSIONS Older adults with SCD, although independent, identified a variety of daily activities that they are not performing satisfactorily, remarkably similar in nature to the occupational performance issues described by older adults with MCI.Implications for RehabilitationOlder adults with SCD identified difficulties in performing social and leisure activities, maintaining healthy lifestyle behaviours, and managing multiple daily tasks.The daily challenges described by older adults with SCD are similar in nature to those identified by those with MCI.Older adults with SCD and MCI describe their daily challenges are related not only to memory problems, but also to executive dysfunction.Interventions for older adults with SCD should aim to improve self-identified problems in everyday functioning.
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Affiliation(s)
- Shlomit Rotenberg
- Rotman Research Institute, Baycrest, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Calvin Leung
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Henry Quach
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest, Toronto, Canada.,Departments of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - Deirdre R Dawson
- Rotman Research Institute, Baycrest, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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23
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Susana CF, Mónica L, Fernando D. Event-related brain potential indexes provide evidence for some decline in healthy people with subjective memory complaints during target evaluation and response inhibition processing. Neurobiol Learn Mem 2021; 182:107450. [PMID: 33933631 DOI: 10.1016/j.nlm.2021.107450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 04/06/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
In the preclinical stage of the Alzheimer's disease (AD) continuum, subjects report subjective memory complaints (SMCs), although with the absence of any objective decline, and have a higher risk of progressing to dementia than the general population. Early identification of this stage therefore constitutes a major focus of current AD research, to enable early intervention. In this study, healthy adult participants with high and low SMCs (HSMCs and LSMCs) performed a Go/NoGo task during electroencephalogram (EEG) recording. Relative to LSMC participants, HSMC participants performed the task slower (longer reaction times) and showed changes in the event-related potential (ERP) components associated with response preparation (lower readiness potential -RP- amplitude in the Go condition), and also related to response inhibition processes (lower N2-P3 amplitude in the NoGo condition). In addition, HSMC participants showed lower Go-N2 and NoGo-N2 peak-to-baseline amplitudes, however these results seem to be influenced by a negative tendency overlapping stimulus-related waveforms. The declines observed in this study are mostly consistent with those observed in aMCI participants, supporting the notion of the AD continuum regarding SMC state.
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24
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YU XIAOFENG, ZHU ZHILONG, ZHENG SHUZHAN, JIANG JIAN, JIANG JUANJUAN, CHU ZHAOHU. IN VIVO ASSESSMENT OF AMYLOID AND GLUCOSE SIGNATURES IN SUBJECTIVE COGNITIVE DECLINE SUBJECTS. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421400182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Subjective cognitive decline (SCD), characterized by self-perceived subtle cognitive impairment ahead of the appearance of explicit and measurable cognitive deficits, is regarded as the preclinical manifestation of the pathological change continuum of Alzheimer’s disease (AD). We were committed to exploring the amyloid and glucose metabolic signatures related to imminent brain metabolic changes in SCD subjects. This study included 39 subjects (mean age = 71.9 years; 14 males and 25 females) diagnosed with SCD disease and 39 gender-matched healthy controls (HCs) (mean age = 75.2; 16 males and 23 females) with brain [18F] fluorodeoxyglucose positron emission tomography (PET) images and [18F] florbetapir PET images. The standardized uptake value ratios (SUVRs) of PET images within the regions of interest (ROIs) were calculated. Inter-group SUVR differences were assessed by two-sample [Formula: see text]-testing and receiver operating characteristic curve (ROC) analyses. A generalized linear model (GLM) was employed to evaluate the correlations between amyloid and FDG uptake. Compared with HCs, SCD subjects showed significantly increased amyloid SUVR, as well as significantly increased glucose SUVR in the olfactory, amygdala, thalamus, heschl gyrus, superior and middle temporal gyrus and temporal pole (all [Formula: see text]). The amyloid SUVR of thalamus was found to have a better ROC result (area under the curve (AUC): 0.77, 95% confidence interval (CI): 0.66–0.86) in the HC group, as was the case with the glucose SUVR of the middle temporal gyrus (AUC: 0.83, 95% CI: 0.73–0.91). There were significant positive correlations between amyloid and glucose SUVRs ([Formula: see text]). The amyloid SUVR of the thalamus showed a significantly better main effect (odd ratio [Formula: see text] 2.91, 95% CI: 1.44–6.7, [Formula: see text]), and the glucose SUVR of the heschl gyrus indicated an enhanced main effect (odd ratio [Formula: see text] 5.08, 95% CI: 1.86–18.15, [Formula: see text]). SCD subjects demonstrated significant amyloid accumulation and glucose hypermetabolism in specific brain regions, and amyloid pathology overlapped with regions of glucose abnormality. These findings may advance the understanding of imminent pathological changes in the SCD stage and help to provide clinical guidelines for interventional management.
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Affiliation(s)
- XIAOFENG YU
- Key Laboratory of Advanced Perception and Intelligent Control of High-end Equipment, Ministry of Education, Anhui Polytechnic University, Anhui 241000, P. R. China
- School of Electrical Engineering, Anhui Polytechnic University, Anhui 241000, P. R. China
| | - ZHILONG ZHU
- Key Laboratory of Advanced Perception and Intelligent Control of High-end Equipment, Ministry of Education, Anhui Polytechnic University, Anhui 241000, P. R. China
- School of Electrical Engineering, Anhui Polytechnic University, Anhui 241000, P. R. China
| | - SHUZHAN ZHENG
- Key Laboratory of Advanced Perception and Intelligent Control of High-end Equipment, Ministry of Education, Anhui Polytechnic University, Anhui 241000, P. R. China
- School of Electrical Engineering, Anhui Polytechnic University, Anhui 241000, P. R. China
| | - JIAN JIANG
- Center of Reproductive Medicine, Yijishan Hospital of Wannan Medical College, Anhui 241001, P. R. China
| | - JUANJUAN JIANG
- Key Laboratory of Advanced Perception and Intelligent Control of High-end Equipment, Ministry of Education, Anhui Polytechnic University, Anhui 241000, P. R. China
- School of Electrical Engineering, Anhui Polytechnic University, Anhui 241000, P. R. China
| | - ZHAOHU CHU
- Department of Neurology, Yijishan Hospital of Wannan Medical College, Anhui 241000, P. R. China
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25
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Kamp SM, Schulz A, Forester G, Domes G. Older adults show a higher heartbeat-evoked potential than young adults and a negative association with everyday metacognition. Brain Res 2021; 1752:147238. [PMID: 33406407 DOI: 10.1016/j.brainres.2020.147238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/11/2020] [Indexed: 11/16/2022]
Abstract
The ability to monitor internal bodily and cognitive processes is essential for everyday functioning and independence in older adults, because it allows for adjustments when lapses in performance are imminent. In the present study, age-related morphological changes to the heartbeat evoked potential (HEP), an electrophysiological cortical representation of cardiac signals, and its association with self-reported everyday cognition were examined. A community sample of older adults showed an increased HEP amplitude, which could reflect a stronger representation of early stages of cardiac interoception, and a more anterior scalp distribution of the HEP, suggesting a more widespread configuration of the underlying neural generators, compared to a group of young adults. Furthermore, in older adults, HEP amplitude was negatively correlated with self-estimated everyday cognitive functioning. Older adults with pronounced cortical representations of peripheral signals may thus be more likely to take note of lapses in their own bodily and cognitive function, leading to lower estimates of their cognitive abilities. These results provide novel insights into age-related changes in interoceptive processing and their association with metacognitive judgments, with potentially far-reaching implications for cognitive aging and age-related cognitive decline.
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Affiliation(s)
- Siri-Maria Kamp
- Neurocognitive Psychology Unit, University of Trier, Germany.
| | | | - Glen Forester
- Neurocognitive Psychology Unit, University of Trier, Germany
| | - Gregor Domes
- Biological and Clinical Psychology Unit, University of Trier, Germany
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26
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Stockmann J, Verberk IMW, Timmesfeld N, Denz R, Budde B, Lange-Leifhelm J, Scheltens P, van der Flier WM, Nabers A, Teunissen CE, Gerwert K. Amyloid-β misfolding as a plasma biomarker indicates risk for future clinical Alzheimer's disease in individuals with subjective cognitive decline. ALZHEIMERS RESEARCH & THERAPY 2020; 12:169. [PMID: 33357241 PMCID: PMC7761044 DOI: 10.1186/s13195-020-00738-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/02/2020] [Indexed: 12/11/2022]
Abstract
Background We evaluated Aβ misfolding in combination with Aβ42/40 ratio as a prognostic tool for future clinical progression to mild cognitive impairment (MCI) or dementia due to Alzheimer’s disease (AD) in individuals with subjective cognitive decline (SCD). Methods Baseline plasma samples (n = 203) from SCD subjects in the SCIENCe project and Amsterdam Dementia Cohort (age 61 ± 9 years; 57% male, mean follow-up time 2.7 years) were analyzed using immuno-infrared-sensor technology. Within 6 years of follow-up, 22 (11%) individuals progressed to MCI or dementia due to AD. Sensor readout values > 1646 cm− 1 reflected normal Aβ folding; readouts at ≤ 1646 cm− 1 reflected low and at < 1644 cm− 1 high misfolding. We used Cox proportional hazard models to quantify Aβ misfolding as a prognostic biomarker for progression to MCI and dementia due to AD. The accuracy of the predicted development of MCI/AD was determined by time-dependent receiver operating characteristic (t-ROC) curve analyses that take individual follow-up and conversion times into account. Statistical models were adjusted for age, sex, and APOEε4 status. Additionally, plasma Aβ42/40 data measured by SIMOA were statistically analyzed and compared. Results All 22 patients who converted to MCI or AD-dementia within 6 years exhibited Aβ misfolding at baseline. Cox analyses revealed a hazard ratio (HR) of 19 (95% confidence interval [CI] 2.2–157.8) for future conversion of SCD subjects with high misfolding and of 11 (95% CI 1.0–110.1) for those with low misfolding. T-ROC curve analyses yielded an area under the curve (AUC) of 0.94 (95% CI 0.86–1.00; 6-year follow-up) for Aβ misfolding in an age, sex, and APOEε4 model. A similar model with plasma Aβ42/40 ratio yielded an AUC of 0.92 (95% CI, 0.82–1.00). The AUC increased to 0.99 (95% CI, 0.99–1.00) after inclusion of both Aβ misfolding and the Aβ42/40 ratio. Conclusions A panel of structure- and concentration-based plasma amyloid biomarkers may predict conversion to clinical MCI and dementia due to AD in cognitively unimpaired subjects. These plasma biomarkers provide a noninvasive and cost-effective alternative for screening early AD pathological changes. Follow-up studies and external validation in larger cohorts are in progress for further validation of our findings. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-020-00738-8.
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Affiliation(s)
- Julia Stockmann
- Competence Center for Biospectroscopy, Center for Protein Diagnostics (PRODI), Ruhr-University Bochum, Bochum, Germany.,Department of Biophysics, Ruhr University Bochum, Faculty of Biology and Biotechnology, Bochum, Germany
| | - Inge M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nina Timmesfeld
- Ruhr University Bochum, Department of Medical Informatics, Biometry and Epidemiology, Bochum, Germany
| | - Robin Denz
- Ruhr University Bochum, Department of Medical Informatics, Biometry and Epidemiology, Bochum, Germany
| | - Brian Budde
- Competence Center for Biospectroscopy, Center for Protein Diagnostics (PRODI), Ruhr-University Bochum, Bochum, Germany.,Department of Biophysics, Ruhr University Bochum, Faculty of Biology and Biotechnology, Bochum, Germany
| | - Julia Lange-Leifhelm
- Competence Center for Biospectroscopy, Center for Protein Diagnostics (PRODI), Ruhr-University Bochum, Bochum, Germany.,Department of Biophysics, Ruhr University Bochum, Faculty of Biology and Biotechnology, Bochum, Germany
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Andreas Nabers
- Competence Center for Biospectroscopy, Center for Protein Diagnostics (PRODI), Ruhr-University Bochum, Bochum, Germany.,Department of Biophysics, Ruhr University Bochum, Faculty of Biology and Biotechnology, Bochum, Germany
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Klaus Gerwert
- Competence Center for Biospectroscopy, Center for Protein Diagnostics (PRODI), Ruhr-University Bochum, Bochum, Germany. .,Department of Biophysics, Ruhr University Bochum, Faculty of Biology and Biotechnology, Bochum, Germany.
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27
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Su XT, Wang LQ, Li JL, Zhang N, Wang L, Shi GX, Yang JW, Liu CZ. Acupuncture Therapy for Cognitive Impairment: A Delphi Expert Consensus Survey. Front Aging Neurosci 2020; 12:596081. [PMID: 33328975 PMCID: PMC7732673 DOI: 10.3389/fnagi.2020.596081] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/16/2020] [Indexed: 01/06/2023] Open
Abstract
Background Current research evidence challenges clinical decision-making when acupuncture is taken into consideration in the treatment of cognitive impairment (CI). Aiming to provide some viable recommendations for acupuncture practitioners in dealing with actual clinic issues, an expert consensus study was conducted. Methods A clinical question investigation among 47 acupuncturists yielded 24 initial items. Subsequently, systematic reviews on acupuncture for CI were searched within three online databases. A panel of 30 authoritative experts were requested to respond with agreement, neutrality, or disagreement for each item. Consensus establishment was defined as the percentage of agreement on a given item >80%. Results Following a 2-round Delphi survey, there were 21 items reaching consensus and three items resulting in no consensus; of which 10 items reached 90∼100% agreement, and 80∼90% expert agreement was achieved for 11 items. These items could be roughly categorized into six domains: (1) therapeutic effects of acupuncture, (2) therapeutic principles, (3) acupoint selection and combination, (4) acupuncture parameters, (5) considerable combined therapies, and (6) possible adverse events. Conclusion Without ready-made guidelines, this expert consensus may be conducive to guide acupuncturists in implementing clinical acupuncture practice for CI. Moreover, given the lack of high-quality research evidence and plenty of unresolved clinical issues in this field, it is of necessity to carry out more studies to better clarify the treatment algorithm.
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Affiliation(s)
- Xin-Tong Su
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jin-Ling Li
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Na Zhang
- School of Acupuncture, Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lu Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Slachevsky A, Zitko P, Martínez-Pernía D, Forno G, Court FA, Lillo P, Villagra R, Duran-Aniotz C, Parrao T, Assar R, Orellana P, Toledo C, Rivera R, Ibañez A, Parra MA, González-Billault C, Amieva H, Thumala D. GERO Cohort Protocol, Chile, 2017-2022: Community-based Cohort of Functional Decline in Subjective Cognitive Complaint elderly. BMC Geriatr 2020; 20:505. [PMID: 33238908 PMCID: PMC7690082 DOI: 10.1186/s12877-020-01866-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/03/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND With the global population aging and life expectancy increasing, dementia has turned a priority in the health care system. In Chile, dementia is one of the most important causes of disability in the elderly and the most rapidly growing cause of death in the last 20 years. Cognitive complaint is considered a predictor for cognitive and functional decline, incident mild cognitive impairment, and incident dementia. The GERO cohort is the Chilean core clinical project of the Geroscience Center for Brain Health and Metabolism (GERO). The objective of the GERO cohort is to analyze the rate of functional decline and progression to clinical dementia and their associated risk factors in a community-dwelling elderly with subjective cognitive complaint, through a population-based study. We also aim to undertake clinical research on brain ageing and dementia disorders, to create data and biobanks with the appropriate infrastructure to conduct other studies and facilitate to the national and international scientific community access to the data and samples for research. METHODS The GERO cohort aims the recruitment of 300 elderly subjects (> 70 years) from Santiago (Chile), following them up for at least 3 years. Eligible people are adults not diagnosed with dementia with subjective cognitive complaint, which are reported either by the participant, a proxy or both. Participants are identified through a household census. The protocol for evaluation is based on a multidimensional approach including socio-demographic, biomedical, psychosocial, neuropsychological, neuropsychiatric and motor assessments. Neuroimaging, blood and stool samples are also obtained. This multidimensional evaluation is carried out in a baseline and 2 follow-ups assessments, at 18 and 36 months. In addition, in months 6, 12, 24, and 30, a telephone interview is performed in order to keep contact with the participants and to assess general well-being. DISCUSSION Our work will allow us to determine multidimensional risks factors associated with functional decline and conversion to dementia in elderly with subjective cognitive complain. The aim of our GERO group is to establish the capacity to foster cutting edge and multidisciplinary research on aging in Chile including basic and clinical research. TRIAL REGISTRATION NCT04265482 in ClinicalTrials.gov. Registration Date: February 11, 2020. Retrospectively Registered.
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Affiliation(s)
- Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile.
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile.
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile.
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
- Department of Neurosciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
| | - Pedro Zitko
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Health Service & Population Research Department, IoPPN, King's College London, London, UK
- Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - David Martínez-Pernía
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Gonzalo Forno
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Felipe A Court
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Center for Integrative Biology, Faculty of Sciences, Universidad Mayor, Santiago, Chile
- The Buck Institute for Research on Aging, Novato, USA
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- South Neurology Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - Roque Villagra
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- East Neurology Department, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Claudia Duran-Aniotz
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Teresa Parrao
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Facultad de Psicología, Universidad Alberto Hurtado, Santiago, Chile
| | - Rodrigo Assar
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Institute of Biomedical Sciences (ICBM), Faculty of Medicine, University of Chile, Santiago, Chile
| | - Paulina Orellana
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Carolina Toledo
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Rodrigo Rivera
- Neuroradiologic Department, Instituto de Neurocirugia Asenjo, SSMO, Santiago, Chile
| | - Agustín Ibañez
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Universidad Autónoma del Caribe, Barranquilla, Colombia
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), California, USA
| | - Mario A Parra
- Universidad Autónoma del Caribe, Barranquilla, Colombia
- Psychology Department, School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Christian González-Billault
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Department of Neurosciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- The Buck Institute for Research on Aging, Novato, USA
- Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Helena Amieva
- INSERM, Bordeaux Population Health Research Center, UMR 1219, Univ. Bordeaux, F-33000, Bordeaux, France
| | - Daniela Thumala
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Escuela de Psicologia, Facultad de Ciencias Sociales, University of Chile, Santiago, Chile
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Conley AC, Albert KM, Boyd BD, Kim SG, Shokouhi S, McDonald BC, Saykin AJ, Dumas JA, Newhouse PA. Cognitive complaints are associated with smaller right medial temporal gray-matter volume in younger postmenopausal women. Menopause 2020; 27:1220-1227. [PMID: 33110037 PMCID: PMC9153070 DOI: 10.1097/gme.0000000000001613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Menopause is associated with increasing cognitive complaints and older women are at increased risk of developing Alzheimer disease compared to men. However, there is difficulty in early markers of risk using objective performance measures. We investigated the impact of subjective cognitive complaints on the cortical structure in a sample of younger postmenopausal women. METHODS Data for this cross-sectional study were drawn from the baseline visit of a longer double-blind study examining estrogen-cholinergic interactions in normal postmenopausal women. Structural Magnetic Resonance Imaging was acquired on 44 women, aged 50-60 years and gray-matter volume was defined by voxel-based morphometry. Subjective measures of cognitive complaints and postmenopausal symptoms were obtained as well as tests of verbal episodic and working memory performance. RESULTS Increased levels of cognitive complaints were associated with lower gray-matter volume in the right medial temporal lobe (r = -0.445, P < 0.002, R = 0.2). Increased depressive symptoms and somatic complaints were also related to increased cognitive complaints and smaller medial temporal volumes but did not mediate the effect of cognitive complaints. In contrast, there was no association between performance on the memory tasks and subjective cognitive ratings, or medial temporal lobe volume. CONCLUSIONS The findings of the present study indicate that the level of reported cognitive complaints in postmenopausal women may be associated with reduced gray-matter volume which may be associated with cortical changes that may increase risk of future cognitive decline. : Video Summary:http://links.lww.com/MENO/A626.
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Affiliation(s)
- Alexander C. Conley
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN
| | - Kimberly M. Albert
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN
| | - Brian D. Boyd
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN
| | - Shin-Gyeom Kim
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN
- Department of Neuropsychiatry, Soonchunhyang University, Bucheon Hospital, Republic of Korea
| | - Sepideh Shokouhi
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN
| | - Brenna C. McDonald
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Andrew J. Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Julie A. Dumas
- Clinical Neuroscience Research Unit, Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT
| | - Paul A. Newhouse
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN
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Poppe M, Mansour H, Rapaport P, Palomo M, Burton A, Morgan-Trimmer S, Carter C, Roche M, Higgs P, Walker Z, Aguirre E, Bass N, Huntley J, Wenborn J, Cooper C. "Falling through the cracks"; Stakeholders' views around the concept and diagnosis of mild cognitive impairment and their understanding of dementia prevention. Int J Geriatr Psychiatry 2020; 35:1349-1357. [PMID: 32608171 DOI: 10.1002/gps.5373] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/08/2020] [Accepted: 06/20/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Many people live with an awareness of mild cognitive changes that increase their dementia risk. Previous authors describe the uncertainties of this liminal state, between cognitive health and dementia, where being "at risk" can itself be an illness. We ask how services respond to people with memory concerns currently, and how a future, effective and inclusive dementia prevention intervention might be structured for people with memory concerns. METHODS/DESIGN We conducted qualitative interviews with 18 people aged 60+ years with subjective or objective memory problems, six family members, 10 health and social care professionals and 11 third sector workers. Interviews were audio-recorded, transcribed and analysed using an inductive thematic approach. RESULTS Three main themes were identified: (1) acknowledging the liminal state, compounded by current, discordant health service responses: medicalising memory concerns yet situating responsibilities for their management with patients and families; (2) enabling change in challenging contexts of physical and cognitive frailty and social disengagement and (3) building on existing values, cultures and routines. CONCLUSIONS Effective dementia prevention must empower individuals to make lifestyle changes within challenging contexts. Programmes must be evidence based yet sufficiently flexible to allow new activities to be fitted into people's current lives; and mindful of the risks of pathologising memory concerns. Most current memory services are neither commissioned, financially or clinically resourced to support people with memory concerns without dementia. Effective, large scale dementia prevention will require a broad societal response.
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Affiliation(s)
- Michaela Poppe
- Division of Psychiatry, University College London, London, UK
| | - Hassan Mansour
- Division of Psychiatry, University College London, London, UK
| | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
| | - Marina Palomo
- Division of Psychiatry, University College London, London, UK
| | | | | | | | - Moïse Roche
- Division of Psychiatry, University College London, London, UK
| | - Paul Higgs
- Division of Psychiatry, University College London, London, UK
| | - Zuzana Walker
- Division of Psychiatry, University College London, London, UK.,Essex Partnership University NHS Foundation Trust, Essex, UK
| | - Elisa Aguirre
- UCL Department of Clinical, Educational and Health Psychology, North East London NHS Foundation Trust, London, UK
| | - Nicholas Bass
- Division of Psychiatry, University College London, London, UK
| | | | - Jennifer Wenborn
- Division of Psychiatry, University College London, London, UK.,North East London NHS Foundation Trust, London, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
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Zokaei N, Sillence A, Kienast A, Drew D, Plant O, Slavkova E, Manohar SG, Husain M. Different patterns of short-term memory deficit in Alzheimer's disease, Parkinson's disease and subjective cognitive impairment. Cortex 2020; 132:41-50. [PMID: 32919108 PMCID: PMC7651994 DOI: 10.1016/j.cortex.2020.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/25/2020] [Accepted: 06/23/2020] [Indexed: 01/06/2023]
Abstract
It has recently been proposed that short-term memory (STM) binding deficits might be an important feature of Alzheimer's disease (AD), providing a potential avenue for earlier detection of this disorder. By contrast, work in Parkinson's disease (PD), using different tasks, has suggested that the STM impairment in this condition is characterised by increased random guessing, possibly due to fluctuating attention. In the present study, to establish whether a misbinding impairment is present in sporadic late-onset AD (LOAD) and increased guessing is a feature of PD, we compared the performance of these patient groups to two control populations: healthy age-matched controls and individuals with subjective cognitive impairment (SCI) with comparable recruitment history as patients. All participants performed a sensitive task of STM that required high resolution retention of object-location bindings. This paradigm also enabled us to explore the underlying sources of error contributing to impaired STM in patients with LOAD and PD using computational modelling of response error. Patients with LOAD performed significantly worse than other groups on this task. Importantly their impaired memory was associated with increased misbinding errors. This was in contrast to patients with PD who made significantly more guessing responses. These findings therefore provide additional support for the presence of two doubly dissociable signatures of STM deficit in AD and PD, with binding impairment in AD and increased random guessing characterising the STM deficit in PD. The task used to measure memory precision here provides an easy-to-administer assessment of STM that is sensitive to the different types of deficit in AD and PD and hence has the potential to inform clinical practice.
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Affiliation(s)
- Nahid Zokaei
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK; Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK.
| | - Annie Sillence
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK
| | - Annika Kienast
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK
| | - Daniel Drew
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK; Wellcome Centre for Integrative Neuroimaging, John Radcliffe Hospital, Oxford, UK
| | - Olivia Plant
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK
| | - Ellie Slavkova
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK
| | - Sanjay G Manohar
- Oxford NIHR Biomedical Research Centre, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - Masud Husain
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK; Oxford NIHR Biomedical Research Centre, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
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Schütz H, Caspers S, Moebus S, Lux S. Prevalence and psychosocial correlates of subjectively perceived decline in five cognitive domains: Results from a population-based cohort study in Germany. Int J Geriatr Psychiatry 2020; 35:1219-1227. [PMID: 32510658 DOI: 10.1002/gps.5359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 05/20/2020] [Accepted: 05/30/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Subjective cognitive decline (SCD) was frequently investigated for memory in healthy aging or in relation to diseases like dementia. It was found to be related to sociodemographic and psychological variables as well as cognitive abilities. The prevalence of SCD in other cognitive domains and their relation to these variables is largely unknown to date. The present study aimed to fill this gap. METHODS A total of 807 subjects (18-85 years of age, M = 57.8 years, female: 43%) completed the Juelich Questionnaire on Subjective Cognitive Decline, to investigate SCD in memory, attention, language, motor, and executive functions. Logistic regression analyses were used to estimate association of depressive symptomatology, emotionality, and general cognitive performance as well as age, gender, and educational attainment with domain-specific SCD. RESULTS The highest prevalence rate was obtained for the memory domain (65.9%), followed by the attention (54.6%), motor (52.9%), executive (39.7%), and language domain (31.5%). Of the psychosocial factors, only age, depressive symptomatology and emotionality were consistently and strongly associated with domain-specific SCD prevalence. CONCLUSIONS SCD is prevalent not only in the memory domain, but also in other major cognitive domains. Our results also suggest that the suspicion from previous research, that subjective memory decline might be more strongly associated with depressive symptomatology and emotionality than with actual decline of cognitive performance, might also apply to the attention, motor, executive, and language domain. Further investigations using neuropsychological testing for specific cognitive functions and employing longitudinal designs are required for substantiating this suspicion.
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Affiliation(s)
- Holger Schütz
- Research Center Jülich, Institute of Neuroscience and Medicine, INM-8, Jülich, Germany
| | - Svenja Caspers
- Research Center Jülich, Institute of Neuroscience and Medicine, INM-1, Jülich, Germany.,Institute for Anatomy I, Medical Faculty, University Düsseldorf, Düsseldorf, Germany.,JARA-BRAIN, Jülich-Aachen Research Alliance, Jülich, Germany
| | - Susanne Moebus
- Institute for Urban Public Health, University Hospitals, University Duisburg-Essen, Duisburg, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Clinic Bonn, Bonn, Germany
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Guzmán-Jiménez DE, Campos JB, Venegas-Vega CA, Sánchez MA, Velasco AL. Familial mesial temporal lobe epilepsy in Mexico: Inheritance pattern and clinical features. Epilepsy Res 2020; 167:106450. [PMID: 32949980 DOI: 10.1016/j.eplepsyres.2020.106450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/11/2020] [Accepted: 08/21/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The objectives of this study were to determine the inheritance pattern by which familial mesial temporal lobe epilepsy (FMTLE) is segregated in Mexican families, and to identify if there was an association between the clinical characteristics and the inheritance pattern. METHOD We included a total of 25 families with two or more members affected with MTLE during two years and elaborated a family pedigree for each family. The inheritance pattern was classified as autosomal dominant (AD) or autosomal recessive (AR), considering the affected members. We used statistical analysis association and differences between clinical characteristics and inheritance patterns. RESULTS The affected families with the AD pattern were 15.7 fold times more likely to start seizures at 5 years of age or earlier than families with AR pattern, OR = 15.7 (IC 95% = 1.9-128.9). We observed a predominance and greater déjà vu association (64.4% vs 31.3%; p = 0.021), OR = 3.9 (CI 95% = 1.1-13.5) in patients with AD versus AR pattern. Finally, we identified that patients with AD pattern had a likelihood of presenting emotional alterations 5.6 times higher than AR (OR = 5.6, IC = 1.1-27.5). CONCLUSION FMTLE is a heterogeneous syndrome, both phenotypically and genotypically; thus, our findings may be helpful for clinical use to perform an early diagnosis, to provide timely treatment, and to prevent comorbidities associated to this disease. However, in order to identify the possible genetic causes underlying these inheritance patterns, the use of molecular studies is necessary.
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Affiliation(s)
- Diana Elena Guzmán-Jiménez
- Epilepsy Clinic, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico; Programa de Doctorado en Ciencias Biomédicas, División de Estudios de Posgrado, Universidad Nacional Autónoma de México (UNAM), Universidad 3000, 04510, Mexico City, Mexico.
| | - Jaime Berumen Campos
- Medical School, Universidad Nacional Autónoma de México, Mexico City, Mexico; Experimental Medicine Unit, Universidad Nacional Autónoma de México, in the General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
| | - Carlos Alberto Venegas-Vega
- Medical School, Universidad Nacional Autónoma de México, Mexico City, Mexico; Genetic Unit, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
| | - Mariana Alejandre Sánchez
- Epilepsy Clinic, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
| | - Ana Luisa Velasco
- Epilepsy Clinic, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
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Rossini F, Zauner H, Bergmann J, Kronbichler M, Spindler I, Golaszewski S, Trinka E, Staffen W. HMPAO-SPECT Can Discriminate between Patients with Subjective Cognitive Complaints with and without Cognitive Deficits and those with Mild Cognitive Impairment. Curr Alzheimer Res 2020; 16:843-851. [PMID: 31453786 DOI: 10.2174/1567205016666190827115138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/09/2019] [Accepted: 08/21/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Growing evidence suggests that pathological processes leading to Alzheimer's disease occurs gradually and begins to develop decades before the earliest clinical symptoms occur. The use of biomarkers has been proposed to detect evidence of preclinical Alzheimer's pathologic change in asymptomatic subjects. Subjective cognitive complaints (SCC) i.e. self-reported cognitive decline with normal cognition have been reported as an indicator of future cognitive decline, however, this condition is unspecific. OBJECTIVE In the present study we used the regional brain perfusion measured by HMPAO-SPECT as Biomarker of neurodegeneration to compare the regional brain perfusion of patient with subjective cognitive complaints with and without minimal cognitive dysfunction (SCC+ and SCC- respectively) in respect to patients with mild cognitive impairment (MCI). METHODS We retrospectively examined 736 Patients who referred to our Memory Clinic because of suspected cognitive dysfunction. After exclusion of patients with overt dementia, automated, quantitatively assessed relative cerebral blood flow of 10 forebrain regions (thalamus, parietotemporal, medial temporal, posterior temporal, posterior cingulate gyrus, each region left hemispheric and right hemispheric) and neuropsychological assessment of 64 SCC (32 SCC+; 32 SCC-) and 28 MCI subjects were analysed. RESULTS .The most relevant differences between groups in cognitive performance concerned verbal memory. Left hemispheric medial temporal region could significantly discriminate between all three groups, with a progressive decrease n perfusion from SCC towards MCI. Area under the curve of left medial temporal region showed a sensitivity of 0,61 and a specificity of 0,78 for discriminating MCI from SCC. CONCLUSION Automated analysis of HMPAO-SPECT data of MCI and SCC+ patients showed significant perfusion differences in medial temporal region and impaired verbal memory, both of which are known features of Alzheimer's disease. Perfusion patterns and verbal memory performance in SCC+ are more similar to MCI than SCC-. Thus, SPECT analysis could distinguish those subjects whose perfusion pattern resembles that of an MCI from those who do not. In our opinion, this could identify two populations with a different risk of progression to AD, with SCC+ subjects needing further diagnostic examination and repeated follow-up.
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Affiliation(s)
- F Rossini
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - H Zauner
- Rehabilitation Center of the Pensionsversicherungsanstalt, Großgmain, Austria
| | - J Bergmann
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria
| | - M Kronbichler
- Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - I Spindler
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - S Golaszewski
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - E Trinka
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - W Staffen
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
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Distribution and clinical impact of apolipoprotein E4 in subjective memory impairment and early mild cognitive impairment. Sci Rep 2020; 10:13365. [PMID: 32770103 PMCID: PMC7414226 DOI: 10.1038/s41598-020-69603-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 06/15/2020] [Indexed: 11/24/2022] Open
Abstract
The apolipoprotein E (APOE) e4 allele is the most common genetic variant associated with Alzheimer’s disease (AD). We sought to investigate the distribution of APOE genotypes across the full clinical AD spectrum including AD, late-stage amnestic mild cognitive impairment (L-aMCI), early-stage aMCI (E-aMCI), subjective memory impairment (SMI), and controls. We prospectively recruited 713 AD patients, 735 aMCI patients, 575 SMI patients, and 8,260 individuals as controls. The frequency of the APOE e4 allele revealed an ordered fashion in the AD (30.8%), L-aMCI (24.0%), E-aMCI (15.1%), SMI (11.7%), and control (9.1%) groups. APOE e3/e4 and e4/e4 genotype frequencies also appeared in an ordered fashion in the AD group (39.1% of e3/e4 and 10.9% of e4/e4), as well as the L-aMCI (28.3% and 9.4%), E-aMCI (22.3% and 3.7%), SMI (18.3% and 1.9%), and control (15.1% and 0.8%) groups. In the comparisons of APOE e3/e3 vs. e3/e4 genotypes, all patient groups had a higher frequency of APOE e3/e4 relative to the control group. Relative to the SMI and E-aMCI groups, the AD and L-aMCI groups had higher frequency of the APOE e3/e4 genotype, and the AD group had a higher frequency relative to the L-aMCI group. However, there was no significant difference between the E-aMCI and SMI groups. In our longitudinal data, APOE e4 carrier showed a steeper incline slope in a clinical dementia rating sum of boxes (CDR-SB) score than APOE e4 non-carrier in SMI (B = 0.0066, p = 0.0104), E-aMCI (B = 0.0313, p < 0.0001), and L-aMCI (B = 0.0178, p = 0.0007). APOE e4 carrier showed a steeper decline slope in the CDR-SB than APOE e4 non-carrier in AD (B = − 0.0309, p = 0.0003). These findings suggest that E-aMCI and SMI are associated with a similarly increased frequency of the APOE e4 allele compared to controls, suggesting a greater genetic risk for AD and the importance of monitoring the allele more closely.
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Cooper C, Aguirre E, Barber JA, Bass N, Brodaty H, Burton A, Higgs P, Hunter R, Huntley J, Lang I, Kales HC, Marchant NL, Minihane AM, Ritchie K, Morgan-Trimmer S, Walker Z, Walters K, Wenborn J, Rapaport P. APPLE-Tree (Active Prevention in People at risk of dementia: Lifestyle, bEhaviour change and Technology to REducE cognitive and functional decline) programme: Protocol. Int J Geriatr Psychiatry 2020; 35:811-819. [PMID: 31833588 DOI: 10.1002/gps.5249] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/07/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Observational studies indicate that approximately a third of dementia cases are attributable to modifiable cardiometabolic, physical and mental health, and social and lifestyle risk factors. There is evidence that intensive behaviour change interventions targeting these factors can reduce cognitive decline. [Figure: see text] METHODS AND ANALYSIS: We will design and test a low intensity, secondary dementia-prevention programme (Active Prevention in People at risk of dementia: Lifestyle, bEhaviour change and Technology to REducE cognitive and functional decline, "APPLE-Tree") to slow cognitive decline in people with subjective cognitive decline with or without objective cognitive impairment. We will embed our work within social science research to understand how dementia prevention is currently delivered and structured. We will carry out systematic reviews and around 50 qualitative interviews with stakeholders, using findings to coproduce the APPLE-Tree intervention. We plan a 10-session group intervention, involving personalised goal-setting, with individual sessions for those unable or unwilling to attend groups, delivered by psychology assistants who will be trained and supervised by clinical psychologists. The coproduction group (including public and patient involvement [PPI], academic and clinical/third-sector professional representatives) will use the Behaviour Change Wheel theoretical framework to develop it. We will recruit and randomly allocate 704 participants, 1:1 to the intervention: informational control group. This sample size is sufficient to detect a between-group difference at 2 years of 0.15 on the primary outcome (cognition: modified neuropsychological test battery; 90% power, 5% significance, effect size 0.25, SD 0.6). DISSEMINATION We will work with Public Health England and third-sector partners to produce an effective national implementation approach, so that if our intervention works, it is used in practice.
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Affiliation(s)
- Claudia Cooper
- Division of Psychiatry, University College London, London, UK
| | - Elisa Aguirre
- Division of Psychiatry, University College London, London, UK
| | - Julie A Barber
- Division of Psychiatry, University College London, London, UK
| | - Nick Bass
- Division of Psychiatry, University College London, London, UK
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Paul Higgs
- Division of Psychiatry, University College London, London, UK
| | - Rachael Hunter
- Division of Psychiatry, University College London, London, UK
| | | | - Iain Lang
- Exeter Medical School, University of Exeter, Exeter, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, University California Davis, Davis, California
| | | | | | | | | | - Zuzana Walker
- Division of Psychiatry, University College London, London, UK
| | - Kate Walters
- Division of Psychiatry, University College London, London, UK
| | | | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
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Cedres N, Machado A, Molina Y, Diaz-Galvan P, Hernández-Cabrera JA, Barroso J, Westman E, Ferreira D. Subjective Cognitive Decline Below and Above the Age of 60: A Multivariate Study on Neuroimaging, Cognitive, Clinical, and Demographic Measures. J Alzheimers Dis 2020; 68:295-309. [PMID: 30741680 DOI: 10.3233/jad-180720] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Subjective cognitive complaints in cognitively normal individuals are a relevant predictor of Alzheimer's disease (AD), cerebrovascular disease, and age-related tauopathy. Complaints starting after the age of 60 increase the likelihood of preclinical AD. However, this criterion is arbitrary and current data show that neurodegenerative disorders likely start before that age. Further, data on the role of subjective complaints below the age of 60 in individuals qualifying for subjective cognitive decline (SCD) are lacking. We investigated the association of subjective cognitive complaints with an extensive number of neuroimaging, demographic, clinical, and cognitive measures in individuals fulfilling criteria for SCD below and above the age of 60. Nine complaints were scored in 416 individuals. Complaints were related to a higher load of white matter signal abnormalities, and this association was stronger the more subclinical changes in personality, interest, and drive were reported. In individuals <60 years, complaints were associated with lower global cognitive performance. In individuals ≥60 years, complaints were related to greater global brain atrophy and smaller total intracranial volume, and this association was stronger the more subclinical difficulties in activities of daily living were reported. Also, complaints were associated with increased depressive symptomatology irrespective of age. We conclude that complaints below the age of 60 may be associated with subtle signs of brain pathology. In the community, screening for risk of future cognitive decline should include subjective cognitive complaints, depressive symptomatology, and subclinical reduced cognition (<60 years)/activities of daily living (≥60 years), supported by basic neuroimaging examinations.
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Affiliation(s)
- Nira Cedres
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.,Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
| | - Alejandra Machado
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.,Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
| | - Yaiza Molina
- Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain.,Faculty of Health Sciences, University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Patricia Diaz-Galvan
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.,Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
| | | | - Jose Barroso
- Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
| | - Eric Westman
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Ferreira
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.,Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain
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Exploring the prevalence of substance-induced neurocognitive disorder among polysubstance users, adding subjective and objective evidence of cognitive impairment. Psychiatry Res 2020; 288:112944. [PMID: 32339804 DOI: 10.1016/j.psychres.2020.112944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/17/2022]
Abstract
UNLABELLED The objective of this study was to explore the prevalence of substance-induced neurocognitive disorder (NCD) in a sample of polysubstance users, adding both objective- and subjective cognitive impairment. METHOD We collected cross-sectional data from 33 community-based residential facilities in Mexico City. Montreal Cognitive Assessment was used for measurement of objective cognitive impairment, and a DSM-5-based interview for subjective impairment. Years and days of recent use of alcohol, marijuana, cocaine and inhalants were collected for regression analyses. RESULTS 753 participants were analyzed; from these, 50.5% show objective impairment, 71% and 58.5% self-reported any cognitive deficit and cognitive decline, respectively. Between 21.8%-36.5% would qualify for NCD when integrating both objective- and subjective impairment (deficit or decline). Significant weak associations were found between objective impairment and subjective deficits in all cognitive domains except social cognition. Regression models adding both objective- and subjective measures explained more variation in the years of alcohol, inhalant and cocaine use, and in recent marijuana use, than the objective measure alone, but associations were inconsistent. CONCLUSION Though significant in proportion, the prevalence of NCD in this population can only be partially related to substance use. Further integrative approaches are needed to refine the epidemiology of this disorder.
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Jenkins A, Tree JJ, Thornton IM, Tales A. Subjective Cognitive Impairment in 55-65-Year-Old Adults Is Associated with Negative Affective Symptoms, Neuroticism, and Poor Quality of Life. J Alzheimers Dis 2020; 67:1367-1378. [PMID: 30689577 PMCID: PMC6398551 DOI: 10.3233/jad-180810] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Although subjective cognitive impairment (SCI) is increasingly recognized clinically and in research as a risk factor for mild cognitive impairment and dementia (particularly Alzheimer’s disease), it is etiologically heterogeneous and potentially treatable. Compared to mild cognitive impairment and Alzheimer’s disease, SCI however remains poorly characterized with debate continuing regarding its clinical relevance. The primary aim of this study was to improve the characterization of SCI within the general public by investigating functions sometimes omitted clinically or in research, namely visual attention-related information processing speed (RT) and its intra-individual variability (IIVRT), general cognition, depression, anxiety, memory, quality of life (QOL), and neuroticism. Compared to individuals without SCI, those with SCI were more likely to reveal higher scores of anxiety, depression, and neuroticism and poorer perceived physical, psychological, and environmental QOL. Within-group analysis identified no significant relationships between any of the above variables for the non-SCI group whereas for the SCI group, poorer Cognitive Change Index scores were significantly correlated with slower RT, raised IIVRT, poorer memory, negative affective symptoms, higher neuroticism scores, and poorer QOL. This indicates that reports of perceived memory changes in SCI can also be associated with other characteristics, namely objectively measured detrimental change in other aspects of brain function and behavior. This outcome emphasizes the importance of a multi-function approach to characterizing and understanding SCI. Thus, although the effect of RT and IIVRT is not strong enough to differentiate SCI from non-SCI at group level, slowing and raised IIVRT do appear to characterize some people with SCI.
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Affiliation(s)
- Amy Jenkins
- Centre for Innovative Ageing, Swansea University, Wales, UK
| | - Jeremy J Tree
- Department of Psychology, Swansea University, Wales, UK
| | - Ian M Thornton
- Department of Cognitive Science, University of Malta, Malta
| | - Andrea Tales
- Centre for Innovative Ageing, Swansea University, Wales, UK
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40
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Si T, Xing G, Han Y. Subjective Cognitive Decline and Related Cognitive Deficits. Front Neurol 2020; 11:247. [PMID: 32508729 PMCID: PMC7248257 DOI: 10.3389/fneur.2020.00247] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022] Open
Abstract
Since late stage dementia, including Alzheimer's disease (AD), cannot be reversed by any available drugs, there is increasing research interest in the preclinical stage of AD, i.e., subjective cognitive decline (SCD). SCD is characterized by self-perceptive cognitive decline but is difficult to detect using objective tests. At SCD stage, the cognitive deficits can be more easily reversed compared to that of mild cognitive impairment (MCI) and AD only if accurate diagnosis of SCD and early intervention can be developed. In this paper, we review the recent progress of SCD research including current assessment tools, biomarkers, neuroimaging, intervention and expected prognosis, and the potential relevance to traumatic brain injury (TBI)-induced cognitive deficits.
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Affiliation(s)
- Tong Si
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guoqiang Xing
- The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical University, Nanchong Central Hospital, Nanchong, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
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41
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Daté Y, Sugiyama D, Tabuchi H, Saito N, Konishi M, Eguchi Y, Momota Y, Yoshizaki T, Mashima K, Mimura M, Nakahara J, Ito D. The utility of simple questions to evaluate cognitive impairment. PLoS One 2020; 15:e0233225. [PMID: 32407392 PMCID: PMC7224527 DOI: 10.1371/journal.pone.0233225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 04/30/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives As the population of patients with cognitive decline grows, physicians and caregivers need brief screening tools. Comprehensive neurocognitive batteries require special training and time for evaluation. We focused on accessibility and compared the diagnostic power of several easy questions. Design “Attended With” (AW) and “Head-Turning Sign” (HTS) factors and participants’ replies to following questions were recorded: “Do you feel that you have more difficulties in your daily life than you used to?”, [no consciousness (C-) or consciousness+ (C+)], “Could you tell me about your daily pleasures or pastimes?” [no pleasure (P-) or pleasure + (P+)], “What are notable current/recent news/topics?” [no news (N-) or news+ (N+)]. Setting This took place in our Memory Clinic between May 2016 and July 2019. Participants We enrolled 162 consecutive cases (44 cognitive normal (CN), 55 amnestic mild cognitive impairment (aMCI), and 48 Alzheimer’s disease (AD)). Measurements The sensitivity and specificity of each battery were calculated, and on account of those numbers, the population attributable risk percent % (PAR%) of (AW and HTS+), (C- and P-), (C- and N-), (P- and N-) as analysis of combination of questions, respectively, were calculated. Results AW had high sensitivity, 87.4, 95.8% (CN vs aMCI + AD, CN + aMCI vs AD) but the sensitivity of HTS was only 46.4, 57.7%, and HTS showed high specificity, 100.0, 71.8%. C- had high sensitivity, 80.6, 87.5%, whereas P- and N- had high specificity, both 83.9% in CN vs aMCI + AD, 88.1% and 75.9% in CN + aMCI vs AD, respectively. In combination analysis, the PAR% of (C- and N-) were as high as (AW and HTS+). Conclusions The combination of (C- and N-) is as powerful as (AW and HTS+) in screening AD. Our findings provide novel insights for screening utility of brief questions “Consciousness of Impairment” and “Recent News.”
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Affiliation(s)
- Yugaku Daté
- Departments of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Daisuke Sugiyama
- Faculty of Nursing and Medical Care Graduate School of Health Management, Keio University, Kanagawa, Japan
| | - Hajime Tabuchi
- Departments of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Naho Saito
- Departments of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Mika Konishi
- Departments of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoko Eguchi
- Departments of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yuki Momota
- Departments of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Takahito Yoshizaki
- Departments of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kyoko Mashima
- Departments of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Masaru Mimura
- Departments of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Jin Nakahara
- Departments of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Daisuke Ito
- Departments of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- * E-mail:
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42
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Adams ML, Grandpre J, Katz DL, Shenson D. Cognitive Impairment and Cardiovascular Disease: A Comparison of Risk Factors, Disability, Quality of Life, and Access to Health Care. Public Health Rep 2020; 135:132-140. [PMID: 31835014 DOI: 10.1177/0033354919893030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Cognitive difficulties or impairment may be an early step in the development of dementia. Several modifiable risk factors for cardiovascular disease (CVD) may also increase the risk of dementia. The objective of our study was to compare adults with subjective cognitive impairment (SCI), using the Behavioral Risk Factor Surveillance System (BRFSS) cognitive disability measure, with adults who reported CVD. METHODS We examined data on 3 key outcomes among 302 008 adult respondents aged ≥45 in the 2017 BRFSS: respondents with SCI only, respondents with CVD only, and respondents with both conditions. We compared measures of disability, quality of life, access to health care, and a composite measure of the following 7 risk factors: current smoking, diabetes, high cholesterol, hypertension, inadequate fruit and vegetable consumption, obesity, and sedentary lifestyle. We also estimated population-attributable risk (PAR). RESULTS Among respondents, 7.9% reported SCI only, 11.1% reported CVD only, and 3.2% reported both conditions, with differences by age and sex. Adults with SCI only were more likely than adults with CVD only to report other disability, worse access to health care, and poorer quality of life, even though adults with CVD were older. Compared with adults with neither condition, adults with any of the 3 outcomes were more likely to report having each of the 7 risk factors; we found a linear association with an increasing number of risk factors. Five or 6 risk factors contributed to PARs for each of the 3 key outcomes. PARs for SCI only were highest for ever smoking (17.2%) and sedentary lifestyle (12.8%), whereas for CVD only, PARs were highest for hypertension (35.5%) and high cholesterol (22.9%). CONCLUSION Despite differences between adults with SCI and adults with CVD in several demographic and health-related measures, the overall similarity in PARs for SCI and CVD suggests potential benefits from using effective CVD interventions to address SCI.
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Affiliation(s)
| | | | - David L Katz
- Yale-Griffin Prevention Research Center, Yale University, New Haven, CT, USA
| | - Douglas Shenson
- Yale School of Medicine, New Haven, CT, USA.,Sickness Prevention Achieved Through Regional Collaboration, Newton, MA, USA
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43
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Norman AL, Woodard JL, Calamari JE, Gross EZ, Pontarelli N, Socha J, DeJong B, Armstrong K. The fear of Alzheimer's disease: mediating effects of anxiety on subjective memory complaints. Aging Ment Health 2020; 24:308-314. [PMID: 30411628 DOI: 10.1080/13607863.2018.1534081] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: To determine if the fear of developing Alzheimer's disease (FDAD) construct, in combination with similar psychoemotional factors, could help elucidate the nature of older adults' subjective memory complaints (SMCs) and subsequent objective memory performance.Methods: One hundred ninety-three healthy older adults (aged 65-93) were administered clinician and self-report measures of depression, worry, anxiety, illness attitudes, and memory, and each rated their concern with developing AD.Results: Self-reported FDAD was not associated with objective memory performance (p > .05). FDAD, trait anxiety, general anxiety, and general and illness-related worry were independently associated with subjective memory report (ps < .05). The relationship between FDAD and subjective memory report was mediated by measures of general trait and state anxiety, but not general worry or illness-specific worry.Conclusions: FDAD was not associated with objective memory functioning, suggesting AD concerns were not reflective of memory pathology. The mediating effect of anxiety on the relationship between FDAD and subjective memory report suggests that assessment of anxiety, beyond AD fear, may help identify older adults at risk for developing negative perceptions of memory and related distress.
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Affiliation(s)
- Andria L Norman
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - John L Woodard
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - John E Calamari
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Evan Z Gross
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Noelle Pontarelli
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Jami Socha
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Brandon DeJong
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Kerri Armstrong
- Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
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44
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Rotenberg S, Maeir A, Dawson DR. Changes in Activity Participation Among Older Adults With Subjective Cognitive Decline or Objective Cognitive Deficits. Front Neurol 2020; 10:1393. [PMID: 32010049 PMCID: PMC6974583 DOI: 10.3389/fneur.2019.01393] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/19/2019] [Indexed: 12/25/2022] Open
Abstract
Participation in daily activities is crucial for healthy aging. There is limited research on participation of older adults with subjective cognitive decline (SCD), defined as the experience of cognitive deficits with no evidence of objective cognitive deficits. Therefore, this study examined perceived changes in participation in this population, and compared it to perceived changes reported by individuals with objective cognitive deficits. The study aimed to: (1) examine the reported changes in activity participation of older with SCD; (2) investigate differences in the reported changes in participation between individuals with SCD and those with mild or severe objective cognitive deficits; (3) examine the relationship between activity participation, subjective memory, and objective cognitive status; and (4) explore whether subjective memory explains additional variance in activity participation after accounting for age and objective cognitive deficits. Participants were 115 older adults (60+), divided into three groups based on their Montreal Cognitive Assessment (MoCA) scores: (1) SCD (MoCA≥26; n = 66); (2) mild objective cognitive deficits (MoCA = 20-25; n = 34); and (3) severe objective cognitive deficits (MoCA ≤ 19; n = 15). The Activity Card Sort was used to measure participation in instrumental activities of daily living, social, and leisure activities. The Multifactorial Memory Questionnaire-Ability subscale was used to assess subjective memory. We found that individuals with SCD, mild cognitive deficits and severe cognitive deficits reported participation withdrawal to a level of 80, 70, and 58% of their past participation, respectively. A significant between group difference was found on participation [χ2(2) = 16.44, p < 0.01], with the SCD group reporting higher participation than the other two groups. Participation significantly correlated with both cognitive status (r = 0.40, p < 0.01) and subjective memory (r = 0.45, p < 0.05). A regression analysis revealed that subjective memory contributed significantly to the explained variance in participation, beyond that accounted for by objective cognitive deficits and age. Our findings demonstrate the important role of subjective memory problems in activity participation of older adults, even in the absence of objective cognitive deficits.
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Affiliation(s)
- Shlomit Rotenberg
- Dawson Lab, Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | - Adina Maeir
- Cog-Fun Lab, School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Deirdre R. Dawson
- Dawson Lab, Rotman Research Institute, Baycrest, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
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45
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Low DV, Wu MN, Spira AP. Sleep Duration and Cognition in a Nationally Representative Sample of U.S. Older Adults. Am J Geriatr Psychiatry 2019; 27:1386-1396. [PMID: 31353188 PMCID: PMC6842702 DOI: 10.1016/j.jagp.2019.07.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/30/2019] [Accepted: 07/01/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Excessive and insufficient sleep have been associated with cognitive dysfunction in older adults in U.S. and non-U.S. STUDIES However, the U.S. studies were not in nationally representative samples. The authors investigated the association between sleep duration and cognitive performance in a nationally representative sample of U.S. older adults. PARTICIPANTS The authors studied 1,496 survey participants aged 60 years or older from the National Health and Nutrition Examination Survey 2013-2014 dataset. MEASUREMENTS Our primary predictor was weekday (or workday) nighttime sleep duration, categorized as 2-4, 5, 6, 7 (reference), 8, 9, and 10 hours or more. The authors studied five cognitive outcomes: Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL) immediate recall, CERAD-WL delayed recall, Animal Fluency Test (AFT), Digital Symbol Substitution Test (DSST), and subjective cognitive problems (SCP). RESULTS After adjusting for age, sex, race, education, depressive symptoms, and sedative-hypnotic use, sleep duration of 10 hours or more was significantly associated with lower scores on CERAD-WL immediate recall, CERAD-WL delayed recall, AFT, and DSST, and greater odds of SCP; sleep duration of 8 hours or more was associated with lower CERAD-WL delayed recall scores: 8, 9, and 10 hours or more. After adjustment, there were no significant associations of shorter sleep duration with cognition. CONCLUSION In U.S. adults aged 60 years or older, long nighttime weekday or workday sleep duration is associated with poorer verbal memory, semantic fluency, working memory, and processing speed in addition to greater odds of self-reported cognitive problems. Long sleep duration may be a marker of fragmented sleep or neurodegeneration in U.S. older adults.
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Affiliation(s)
- Dominique V. Low
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Mark N. Wu
- Department of Neurology, Johns Hopkins University, Baltimore, MD 21205
| | - Adam P. Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205,Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205,Johns Hopkins University Center on Aging and Health, Baltimore, MD 21205
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46
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Yan CQ, Zhou P, Wang X, Tu JF, Hu SQ, Huo JW, Wang ZY, Shi GX, Zhang YN, Li JQ, Wang J, Liu CZ. Efficacy and neural mechanism of acupuncture treatment in older adults with subjective cognitive decline: study protocol for a randomised controlled clinical trial. BMJ Open 2019; 9:e028317. [PMID: 31601583 PMCID: PMC6797373 DOI: 10.1136/bmjopen-2018-028317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Subjective cognitive decline (SCD) refers to individuals' perceived decline in memory and/or other cognitive abilities relative to their previous level of performance, while objective neuropsychological deficits are not observed. SCD may represent a preclinical phase of Alzheimer's disease. At this very early stage of decline, intervention could slow the rate of incipient decline to prolong and preserve cognitive and functional abilities. However, there is no effective treatment recommended for individuals with SCD. Acupuncture, as a non-pharmacological intervention, has been widely employed for patients with cognitive disorders. METHODS AND ANALYSIS The proposed study is a randomised, assessor-blinded and placebo-controlled study that investigates the efficacy and mechanism of acupuncture in SCD. Sixty patients with SCD will be randomly allocated either into an acupuncture group or a sham acupuncture group. They will receive 24 sessions of real acupuncture treatment or identical treatment sessions using a placebo needle. Global cognitive changes based on a multidomain neuropsychological test battery will be evaluated to detect the clinical efficacy of acupuncture treatment at baseline and end of treatment. MRI scans will be used to explore acupuncture-related neuroplasticity changes. Correlation analyses will be performed to investigate the relationships between the changes in brain function and symptom improvement. ETHICS AND DISSEMINATION The trial was approved by the research ethics committee. The results of the study will be published in a peer-reviewed academic journal and will also be disseminated electronically through conference presentations. TRIAL REGISTRATION NUMBER NCT03444896.
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Affiliation(s)
- Chao-Qun Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
- Department of Acupuncture and moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Ping Zhou
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Jian Feng Tu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shang-Qing Hu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Wei Huo
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Zhong-Yan Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Guang-Xia Shi
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ya-Nan Zhang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jun-Qiu Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jun Wang
- Department of Acupuncture and moxibustion, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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47
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Miebach L, Wolfsgruber S, Polcher A, Peters O, Menne F, Luther K, Incesoy E, Priller J, Spruth E, Altenstein S, Buerger K, Catak C, Janowitz D, Perneczky R, Utecht J, Laske C, Buchmann M, Schneider A, Fliessbach K, Kalbhen P, Heneka MT, Brosseron F, Spottke A, Roy N, Teipel SJ, Kilimann I, Wiltfang J, Bartels C, Düzel E, Dobisch L, Metzger C, Meiberth D, Ramirez A, Jessen F, Wagner M. Which features of subjective cognitive decline are related to amyloid pathology? Findings from the DELCODE study. ALZHEIMERS RESEARCH & THERAPY 2019; 11:66. [PMID: 31366409 PMCID: PMC6668160 DOI: 10.1186/s13195-019-0515-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/02/2019] [Indexed: 12/14/2022]
Abstract
Background Subjective cognitive decline (SCD) has been proposed as a pre-MCI at-risk condition of Alzheimer’s disease (AD). Current research is focusing on a refined assessment of specific SCD features associated with increased risk for AD, as proposed in the SCD-plus criteria. We developed a structured interview (SCD-I) for the assessment of these features and tested their relationship with AD biomarkers. Methods We analyzed data of 205 cognitively normal participants of the DELCODE study (mean age = 68.9 years; 52% female) with available CSF AD biomarkers (Aß-42, p-Tau181, Aß-42/Tau ratio, total Tau). For each of five cognitive domains (including memory, language, attention, planning, others), a study physician asked participants about the following SCD-plus features: the presence of subjective decline, associated worries, onset of SCD, feeling of worse performance than others of the same age group, and informant confirmation. We compared AD biomarkers of subjects endorsing each of these questions with those who did not, controlling for age. SCD was also quantified by two summary scores: the number of fulfilled SCD-plus features, and the number of domains with experienced decline. Covariate-adjusted linear regression analyses were used to test whether these SCD scores predicted abnormality in AD biomarkers. Results Lower Aß-42 levels were associated with a reported decline in memory and language abilities, and with the following SCD-plus features: onset of subjective decline within 5 years, confirmation of cognitive decline by an informant, and decline-related worries. Furthermore, both quantitative SCD scores were associated with lower Aß42 and lower Aß42/Tau ratio, but not with total Tau or p-Tau181. Conclusions Findings support the usefulness of a criterion-based interview approach to assess and quantify SCD in the context of AD and validate the current SCD-plus features as predictors of AD pathology. While some features seem to be more closely associated with AD biomarkers than others, aggregated scores over several SCD-plus features or SCD domains may be the best predictors of AD pathology. Electronic supplementary material The online version of this article (10.1186/s13195-019-0515-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lisa Miebach
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany. .,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Alexandra Polcher
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Oliver Peters
- Institute of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Felix Menne
- Institute of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Katja Luther
- Institute of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Enise Incesoy
- Institute of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Eike Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Cihan Catak
- Institute for Stroke and Dementia Research (ISD), LMU Munich, Munich, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), LMU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Ludwig-Maximilians-Universität München, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Julia Utecht
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Martina Buchmann
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Hertie-Institute for Clinical Brain Research, Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Pascal Kalbhen
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Frederic Brosseron
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department of Neurology, University of Bonn, Bonn, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
| | - Stefan J Teipel
- Department of Psychosomatic Medicine, University of Medicine, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Ingo Kilimann
- Department of Psychosomatic Medicine, University of Medicine, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.,Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Claudia Bartels
- German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.,Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Emrah Düzel
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany.,German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Coraline Metzger
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany.,German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - Dix Meiberth
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Alfredo Ramirez
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases/Clinical Research, Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Zentrum für klinische Forschung/AG Neuropsychologie, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany
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48
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Flatt JD, Johnson JK, Karpiak SE, Seidel L, Larson B, Brennan-Ing M. Correlates of Subjective Cognitive Decline in Lesbian, Gay, Bisexual, and Transgender Older Adults. J Alzheimers Dis 2019; 64:91-102. [PMID: 29865050 DOI: 10.3233/jad-171061] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Little is known about subjective cognitive decline (SCD) in lesbian, gay, bisexual, and transgender (LGBT) older adults. OBJECTIVES To examine SCD and its association with dementia risk factors, other physical and psychosocial health factors in LGBT older adults. METHODS A cross-sectional study of SCD was conducted with LGBT older adults, aged 50 and older (n = 210). SCD was categorized based on endorsement of memory problems and one other cognitive domain. Hierarchical logistic regression examined the associations between demographic factors, dementia risk factors, other health and psychosocial factors, and SCD. RESULTS Nearly 25% of LGBT older adults were classified as having SCD. LGBT older adults who were people of color (OR = 2.5; 95% CI = 1.1- 7.8), depressed (OR = 2.9; 95% CI = 1.3- 6.9), or reported having functional impairment (OR = 2.6; 95% CI = 1.1- 6.5) were significantly more likely to be classified as having SCD (Nagelkerke pseudo R2 = 0.27). CONCLUSION Depression and functional impairment should be considered when screening LGBT older adults for cognitive impairment and dementia. Future research on the cognitive impairment and dementia risk in LGBT older adults is needed.
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Affiliation(s)
- Jason D Flatt
- University of California, San Francisco (UCSF), San Francisco, CA, USA.,UCSF Center for Aging in Diverse Communities, San Francisco, CA, USA
| | - Julene K Johnson
- University of California, San Francisco (UCSF), San Francisco, CA, USA.,UCSF Center for Aging in Diverse Communities, San Francisco, CA, USA
| | - Stephen E Karpiak
- ACRIA Center on HIV and Aging at GMHC, New York, NY, USA and San Francisco, CA, USA.,New York University College of Nursing, New York, NY, USA
| | - Liz Seidel
- ACRIA Center on HIV and Aging at GMHC, New York, NY, USA and San Francisco, CA, USA.,Fordham University, New York, NY, USA
| | | | - Mark Brennan-Ing
- New York University College of Nursing, New York, NY, USA.,Brookdale Center for Healthy Aging, Hunter College, City University of New York, New York, NY, USA
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49
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Depressed mood and cognitive deficits as distinct mechanisms of subjective memory and executive complaints. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2019. [DOI: 10.5114/cipp.2018.81689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BackgroundSubjective cognitive decline (SCD) is the sense of deterioration in cognitive functioning in terms of memory, executive function, attention, etc. SCD is reported by nearly 70% of the population. Very intensive research on the predictive role of SCD in the development of dementia and determinants SCD did not bring common solutions. For exploration of the phenomenon, studies were undertaken in order to identify: a) on the basis of which factors a high level of SCD can be predicted, and b) whether these factors have similar prognostic value for two types of SCD, i.e. concerning executive function (SED) and memory (SMD).Participants and procedureThe study involved 274 Polish people aged 18 to 84 years (M = 53.23, SD = 16.8). For the evaluation of SCD three methods were used: memory self-assessment scales (ProCog and MARS), and an executive functions self-assessment scale (DEX-S). Subtests of the WAIS-PL to assess cognitive function were used, and GDS-15 or BECK II to assess the severity of depressive mood. In the first stage, two separate cluster analyses (k-means method) were performed: the first related to the results of the memory self-assessment scale (ProCog and MARS), the second to the subjective difficulty of executive functions (DEX-S). In step II a logistic regression analysis of the forward selection with the likelihood ratio and interaction effects was performed – separately for the two types of self-reports.ResultsThe results indicate that higher depressed mood increases the likelihood of both the SMD and SED. Higher efficiency attention-al processes reduce the possibility of formulating the SED, and higher efficiency of the delayed memory, abstract thinking, or certain aspects of language functions reduces the possibility of SMD.ConclusionsThere are two independent mechanisms of SCD – emotional and cognitive.
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50
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Verfaillie SCJ, Timmers T, Slot RER, van der Weijden CWJ, Wesselman LMP, Prins ND, Sikkes SAM, Yaqub M, Dols A, Lammertsma AA, Scheltens P, Ossenkoppele R, van Berckel BNM, van der Flier WM. Amyloid-β Load Is Related to Worries, but Not to Severity of Cognitive Complaints in Individuals With Subjective Cognitive Decline: The SCIENCe Project. Front Aging Neurosci 2019; 11:7. [PMID: 30760996 PMCID: PMC6362417 DOI: 10.3389/fnagi.2019.00007] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/10/2019] [Indexed: 02/05/2023] Open
Abstract
Objective: Subjective cognitive decline (SCD) is associated with an increased risk of Alzheimer's Disease (AD). Early disease processes, such as amyloid-β aggregation measured with quantitative PET, may help to explain the phenotype of SCD. The aim of this study was to investigate whether quantitative amyloid-β load is associated with both self- and informant-reported cognitive complaints and memory deficit awareness in individuals with SCD. Methods: We included 106 SCD patients (mean ± SD age: 64 ± 8, 45%F) with 90 min dynamic [18F]florbetapir PET scans. We used the following questionnaires to assess SCD severity: cognitive change index (CCI, self and informant reports; 2 × 20 items), subjective cognitive functioning (SCF, four items), and five questions "Do you have complaints?" (yes/no) for memory, attention, organization and language), and "Does this worry you? (yes/no)." The Rivermead Behavioral Memory Test (RBMT)-Stories (immediate and delayed recall) was used to assess objective episodic memory. To investigate the level of self-awareness, we calculated a memory deficit awareness index (Z-transformed (inverted self-reported CCI minus episodic memory); higher index, heightened self-awareness) and a self-proxy index (Z-transformed self- minus informant-reported CCI). Mean cortical [18F]florbetapir binding potential (BPND) was derived from the PET data. Logistic and linear regression analyses, adjusted for age, sex, education, and depressive symptoms, were used to investigate associations between BPND and measures of SCD. Results: Higher mean cortical [18F]florbetapir BPND was associated with SCD-related worries (odds ratio = 1.76 [95%CI = 1.07 ± 2.90]), but not with other SCD questionnaires (informant and self-report CCI or SCF, total scores or individual items, all p > 0.05). In addition, higher mean cortical [18F]florbetapir BPND was associated with a higher memory deficit awareness index (Beta = 0.55), with an interaction between BPND and education (p = 0.002). There were no associations between [18F]florbetapir BPND and self-proxy index (Beta = 0.11). Conclusion: Amyloid-β deposition was associated with SCD-related worries and heightened memory deficit awareness (i.e., hypernosognosia), but not with severity of cognitive complaints. Our findings indicate that worries about self-perceived decline may reflect an early symptom of amyloid-β related pathology rather than subjective cognitive functioning.
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Affiliation(s)
- Sander C J Verfaillie
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Tessa Timmers
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Rosalinde E R Slot
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Chris W J van der Weijden
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Linda M P Wesselman
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Niels D Prins
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Sietske A M Sikkes
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Annemiek Dols
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Old Age Psychiatry, Amsterdam Neuroscience, GGZ inGeest, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Rik Ossenkoppele
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands.,Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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