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Karami V, Yaffe MJ, Gore G, Moon AJ, Abbasgholizadeh Rahimi S. Socially Assistive Robots for patients with Alzheimer's Disease: A scoping review. Arch Gerontol Geriatr 2024; 123:105409. [PMID: 38565072 DOI: 10.1016/j.archger.2024.105409] [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: 12/29/2022] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The most common form of dementia, Alzheimer's Disease (AD), is challenging for both those affected as well as for their care providers, and caregivers. Socially assistive robots (SARs) offer promising supportive care to assist in the complex management associated with AD. OBJECTIVES To conduct a scoping review of published articles that proposed, discussed, developed or tested SAR for interacting with AD patients. METHODS We performed a scoping review informed by the methodological framework of Arksey and O'Malley and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist for reporting the results. At the identification stage, an information specialist performed a comprehensive search of 8 electronic databases from the date of inception until January 2022 in eight bibliographic databases. The inclusion criteria were all populations who recive or provide care for AD, all interventions using SAR for AD and our outcomes of inteerst were any outcome related to AD patients or care providers or caregivers. All study types published in the English language were included. RESULTS After deduplication, 1251 articles were screened. Titles and abstracts screening resulted to 252 articles. Full-text review retained 125 included articles, with 72 focusing on daily life support, 46 on cognitive therapy, and 7 on cognitive assessment. CONCLUSION We conducted a comprehensive scoping review emphasizing on the interaction of SAR with AD patients, with a specific focus on daily life support, cognitive assessment, and cognitive therapy. We discussed our findings' pertinence relative to specific populations, interventions, and outcomes of human-SAR interaction on users and identified current knowledge gaps in SARs for AD patients.
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Affiliation(s)
- Vania Karami
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Mila - Quebec AI Institute, Montreal, Canada
| | - Mark J Yaffe
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada; St. Mary's Hospital Center, Montreal, Canada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Canada
| | - AJung Moon
- Department of Electrical & Computer Engineering, Faculty of Engineering, McGill University, Montreal, Canada
| | - Samira Abbasgholizadeh Rahimi
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Mila - Quebec AI Institute, Montreal, Canada; Faculty of Dental Medicine and Oral Health Sciences.
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Chang KH, Wang C, Nester CO, Katz MJ, Byrd DA, Lipton RB, Rabin LA. Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study. Front Aging Neurosci 2023; 15:1221768. [PMID: 38076542 PMCID: PMC10702963 DOI: 10.3389/fnagi.2023.1221768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/29/2023] [Indexed: 01/28/2024] Open
Abstract
Objective The role of subjective cognitive concerns (SCC) as a diagnostic criterion for MCI remains uncertain and limits the development of a universally (or widely)-accepted MCI definition. The optimal MCI definition should define an at-risk state and accurately predict the development of incident dementia. Questions remain about operationalization of definitions of self- and informant-reported SCCs and their individual and joint associations with incident dementia. Methods The present study included Einstein Aging Study participants who were non-Hispanic White or Black, free of dementia at enrollment, had follow-up, and completed neuropsychological tests and self-reported SCC at enrollment to determine MCI status. Informant-reported SCC at baseline were assessed via the CERAD clinical history questionnaire. Self-reported SCC were measured using the CERAD, items from the EAS Health Self-Assessment, and the single memory item from the Geriatric Depression Scale. Cox proportional hazards models examined the association of different operationalizations of SCC with Petersen and Jak/Bondi MCI definitions on the risk of dementia, further controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at specific time points for each definition, and Youden's index were calculated as an accuracy measure. Cox proportional hazards models were also used to evaluate the associations of combinations of self- and informant-reported SCC with the risk of incident dementia. Results 91% of the sample endorsed at least one SCC. Youden's index showed that not including SCC in either Jak/Bondi or Petersen classifications had the best balance between sensitivity and specificity across follow-up. A subset of individuals with informants, on average, had a lower proportion of non-Hispanic Blacks and 94% endorsed at least one self-reported SCC. Both informant-reported and self-reported SCC were significantly associated with incident dementia. Conclusion Our findings suggest that the SCC criterion may not improve the predictive validity for dementia when included in widely-employed definitions of MCI. Consistent with some prior research, informant-reported SCC was more related to risk of incident dementia than self-reported SCC. Given that requiring informant report as a diagnostic criterion may unintentionally exclude health disparate groups, additional consideration is needed to determine how best to utilize informant-report in MCI diagnosis.
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Affiliation(s)
- Katherine H. Chang
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Caroline O. Nester
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Desiree A. Byrd
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
| | - Richard B. Lipton
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Laura A. Rabin
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Psychology, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, United States
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Santos Henriques RPD, Tomas-Carus P, Filipe Marmeleira JF. Association Between Neuropsychological Functions and Activities of Daily Living in People with Mild Cognitive Impairment. Exp Aging Res 2023; 49:457-471. [PMID: 36242522 DOI: 10.1080/0361073x.2022.2133292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/03/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The aim of this study was to explore the relationship between performance in neurocognitive variables and daily functioning (basic or b- and instrumental or i-ADL) in people with mild cognitive impairment (MCI). METHODS A sample of 157 participants with MCI (73.65 ± 7.58 years) completed a battery of tests for assessing ADL and cognitive functions. t-test, Pearson's correlation and multiple linear regression (backward stepwise selection) were used for data analyses. RESULTS Significant correlations were found between b- and i-ADL, and several neuropsychological tests (p < .01). Multivariate analysis showed that difficulties in Blessed Rating Scales (BLS) explained 33.2% of the variation in b-ADL and that this variation rises to 42.9% when BLS is associated with Frontal Assessment Battery Flexibility, Trail Making Test A (TMT-A) and BLS Personality. For i-ADL, BLS and Dementia Rating Scale Total (DRS-T) explained 47.7% of the variation and the inclusion in the model of BLS, DRS-IP (Initiation/Perseveration), TMT-A and BLS Personality explained 53.5% of this variation. Executive functions explained 24.8% of the variation in i-ADL. CONCLUSIONS Cognitive functions are related to i- and b-ADL in people with MCI. The general indicators and those that assess executive functions and verbal- or visual-spatial memory should be considered to predict i-ADL.
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Affiliation(s)
- Rogério Paulo Dos Santos Henriques
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais, Portugal
| | - Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais, Portugal
| | - José Francisco Filipe Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, Portugal
- Comprehensive Health Research Center (CHRC), Universidade de Évora, Largo dos Colegiais, Portugal
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Baik JS, Min JH, Ko SH, Yun MS, Lee B, Kang NY, Kim B, Lee H, Shin YI. Effects of Home-Based Computerized Cognitive Training in Community-Dwelling Adults With Mild Cognitive Impairment. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2023; 12:97-105. [PMID: 38088994 PMCID: PMC10712670 DOI: 10.1109/jtehm.2023.3317189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/03/2023] [Accepted: 09/12/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE There is a growing importance for the home-based (HB) support services, and computerized cognitive training (CCT) has been reported as an effective intervention for cognitive impairment. However, there is still a need for further verification of the effect of HB-CCT. This study aimed to determine the effectiveness of HB-CCT on the cognitive function of community-dwelling adults with mild cognitive impairment (MCI) as well as safety in its use. METHODS Fifty community-dwelling adults with MCI were included, of which 25 each were randomized to either HB-CCT or control groups. Evaluations of comprehensive cognition, memory, attention, language, executive function, and depression were performed before and after the intervention, including three times a week for eight weeks in the intervention group and eight weeks apart with no intervention in the control group. RESULTS In baseline and post-evaluation comparisons, the HB-CCT group showed significant improvements, while the control group did not show significant changes. Statistically significant variations were noted between the HB-CCT and control groups in all post-intervention evaluations relative to baseline. Additionally, no side effects were observed. CONCLUSION Beneficial effects on cognition and depression were noted in the intervention group compared with the control group, suggesting that HB-CCT may be a positive tool for cognitive improvement in adults with MCI.
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Affiliation(s)
- Ji Soo Baik
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan HospitalYangsan50612Republic of Korea
| | - Ji Hong Min
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
| | - Sung-Hwa Ko
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
- Department of Rehabilitation MedicineThe Graduate School of MedicinePusan National UniversityYangsan50612Republic of Korea
| | - Mi Sook Yun
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan HospitalYangsan50612Republic of Korea
| | - Byunghoon Lee
- Department of Rehabilitation MedicinePusan National University HospitalBusan46241Republic of Korea
| | - Nae Yoon Kang
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
| | | | | | - Yong-Il Shin
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
- Department of Rehabilitation MedicineThe Graduate School of MedicinePusan National UniversityYangsan50612Republic of Korea
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Jones KT, Gallen CL, Ostrand AE, Rojas JC, Wais P, Rini J, Chan B, Lago AL, Boxer A, Zhao M, Gazzaley A, Zanto TP. Gamma neuromodulation improves episodic memory and its associated network in amnestic mild cognitive impairment: a pilot study. Neurobiol Aging 2023; 129:72-88. [PMID: 37276822 PMCID: PMC10583532 DOI: 10.1016/j.neurobiolaging.2023.04.005] [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: 09/06/2022] [Revised: 04/10/2023] [Accepted: 04/17/2023] [Indexed: 06/07/2023]
Abstract
Amnestic mild cognitive impairment (aMCI) is a predementia stage of Alzheimer's disease associated with dysfunctional episodic memory and limited treatment options. We aimed to characterize feasibility, clinical, and biomarker effects of noninvasive neurostimulation for aMCI. 13 individuals with aMCI received eight 60-minute sessions of 40-Hz (gamma) transcranial alternating current stimulation (tACS) targeting regions related to episodic memory processing. Feasibility, episodic memory, and plasma Alzheimer's disease biomarkers were assessed. Neuroplastic changes were characterized by resting-state functional connectivity (RSFC) and neuronal excitatory/inhibitory balance. Gamma tACS was feasible and aMCI participants demonstrated improvement in multiple metrics of episodic memory, but no changes in biomarkers. Improvements in episodic memory were most pronounced in participants who had the highest modeled tACS-induced electric fields and exhibited the greatest changes in RSFC. Increased RSFC was also associated with greater hippocampal excitability and higher baseline white matter integrity. This study highlights initial feasibility and the potential of gamma tACS to rescue episodic memory in an aMCI population by modulating connectivity and excitability within an episodic memory network.
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Affiliation(s)
- Kevin T Jones
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Neuroscape, University of California-San Francisco, San Francisco, CA.
| | - Courtney L Gallen
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Neuroscape, University of California-San Francisco, San Francisco, CA
| | - Avery E Ostrand
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Neuroscape, University of California-San Francisco, San Francisco, CA
| | - Julio C Rojas
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Weill Institute for Neurosciences, Memory and Aging Center, University of California-San Francisco, San Francisco, CA
| | - Peter Wais
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Neuroscape, University of California-San Francisco, San Francisco, CA
| | - James Rini
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Neuroscape, University of California-San Francisco, San Francisco, CA
| | - Brandon Chan
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Weill Institute for Neurosciences, Memory and Aging Center, University of California-San Francisco, San Francisco, CA
| | - Argentina Lario Lago
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Weill Institute for Neurosciences, Memory and Aging Center, University of California-San Francisco, San Francisco, CA
| | - Adam Boxer
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Weill Institute for Neurosciences, Memory and Aging Center, University of California-San Francisco, San Francisco, CA
| | - Min Zhao
- Departments of Ophthalmology and Vision Science and Dermatology, Institute for Regenerative Cures, University of California-Davis, Davis, CA
| | - Adam Gazzaley
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Neuroscape, University of California-San Francisco, San Francisco, CA; Departments of Physiology and Psychiatry, University of California-San Francisco, San Francisco, CA
| | - Theodore P Zanto
- Department of Neurology, University of California-San Francisco, San Francisco, CA; Neuroscape, University of California-San Francisco, San Francisco, CA.
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Pommy J, Conant L, Butts AM, Nencka A, Wang Y, Franczak M, Glass-Umfleet L. A graph theoretic approach to neurodegeneration: five data-driven neuropsychological subtypes in mild cognitive impairment. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:903-922. [PMID: 36648118 DOI: 10.1080/13825585.2022.2163973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/26/2022] [Indexed: 01/18/2023]
Abstract
Mild cognitive Impairment (MCI) is notoriously heterogenous in terms of clinical presentation, neuroimaging correlates, and subsequent progression. Predicting who will progress to dementia, which type of dementia, and over what timeframe is challenging. Previous work has attempted to identify MCI subtypes using neuropsychological measures in an effort to address this challenge; however, there is no consensus on approach, which may account for some of the variability. Using a hierarchical community detection approach, we examined cognitive subtypes within an MCI sample (from the Alzheimer's Disease Neuroimaging Initiative [ADNI] study). We then examined whether these subtypes were related to biomarkers (e.g., cortical volumes, fluorodeoxyglucose (FDG)-positron emission tomography (PET) hypometabolism) or clinical progression. We identified five communities (i.e., cognitive subtypes) within the MCI sample: 1) predominantly memory impairment, 2) predominantly language impairment, 3) cognitively normal, 4) multidomain, with notable executive dysfunction, 5) multidomain, with notable processing speed impairment. Community membership was significantly associated with 1) cortical volume in the hippocampus, entorhinal cortex, and fusiform cortex; 2) FDG PET hypometabolism in the posterior cingulate, angular gyrus, and inferior/middle temporal gyrus; and 3) conversion to dementia at follow up. Overall, community detection as an approach appears a viable method for identifying unique cognitive subtypes in a neurodegenerative sample that were linked to several meaningful biomarkers and modestly with progression at one year follow up.
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Affiliation(s)
- Jessica Pommy
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - L Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - A M Butts
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - A Nencka
- Department of Radiology, Medical College of Wisconsin, Milwaukee, United States
| | - Y Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, United States
| | - M Franczak
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - L Glass-Umfleet
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
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Sempere-Bigorra M, Julián-Rochina I, Pérez-Ros P, Navarro-Flores E, Martínez-Arnau FM, Cauli O. Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life. Life (Basel) 2023; 13:1790. [PMID: 37763194 PMCID: PMC10532541 DOI: 10.3390/life13091790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/01/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
Aging is an inevitable process that impacts the peripheral and central nervous systems and is considered one of the strongest risk factors for neurodegenerative diseases. In addition, when it also presents with diabetes mellitus, the risk of neurological damage may be further increased. This current study aimed to explore the relationships between peripheral sensory system decline and cognitive functions, the symptoms of depression, and quality of life (QoL) as metrics of central nervous system impairment in institutionalized older adults. A total of 95 individuals participated in this case-control study, which included diabetics and non-diabetics. The superficial sensory pathway was assessed in terms of thermal sensation, nociception, and non-discriminative touch, and the deep sensory pathway was evaluated by assessing vibration and light touch-pressure sensations. To assess function at the intellectual level, the Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) cognitive functional tests were used, while the symptoms of depression and QoL were explored by employing the Yesavage Geriatric Depression Scale and EuroQol 5D questionnaire (EQ-5D), respectively. In the overall population analyses, altered thermal sensation was significantly associated with cognitive impairment (CI; p < 0.05). In turn, bivariate analyses and a binary logistic regression showed that the symptoms of depression and QoL were significantly related to altered vibratory sensation when assessed using a medical tuning fork (p < 0.05). In the group of diabetic patients, those with CI also had significantly lower thermal sensation (p < 0.05) and non-discriminative touch sensation, although this was only a trend (p = 0.055). Diabetics with depression had a significantly worse non-discriminative touch (p < 0.05) and vibratory sensation when tested with a tuning fork (p < 0.05). In addition, poorer QoL was associated with reduced sensitivity to heat (p < 0.05), light touch pressure (p < 0.05), and vibrations when assessed either with a tuning fork (p < 0.05) or a biothesiometer (p < 0.05). In contrast, no relationships were found between sensory functions and cognitive assessments in non-diabetic patients. These findings indicate that superficial sensitivity damage was related to CI, while deep sensation alterations were related to depression and poor QoL, with diabetes apparently further strengthening these relationships.
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Affiliation(s)
- Mar Sempere-Bigorra
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain; (M.S.-B.); (I.J.-R.); (P.P.-R.); (E.N.-F.)
- Frailty Research Organized Group (FROG), Department of Nursing, University of Valencia, 46010 Valencia, Spain;
| | - Iván Julián-Rochina
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain; (M.S.-B.); (I.J.-R.); (P.P.-R.); (E.N.-F.)
- Frailty Research Organized Group (FROG), Department of Nursing, University of Valencia, 46010 Valencia, Spain;
| | - Pilar Pérez-Ros
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain; (M.S.-B.); (I.J.-R.); (P.P.-R.); (E.N.-F.)
- Frailty Research Organized Group (FROG), Department of Nursing, University of Valencia, 46010 Valencia, Spain;
| | - Emmanuel Navarro-Flores
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain; (M.S.-B.); (I.J.-R.); (P.P.-R.); (E.N.-F.)
- Frailty Research Organized Group (FROG), Department of Nursing, University of Valencia, 46010 Valencia, Spain;
| | - Francisco Miguel Martínez-Arnau
- Frailty Research Organized Group (FROG), Department of Nursing, University of Valencia, 46010 Valencia, Spain;
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain; (M.S.-B.); (I.J.-R.); (P.P.-R.); (E.N.-F.)
- Frailty Research Organized Group (FROG), Department of Nursing, University of Valencia, 46010 Valencia, Spain;
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Wang Y, Yang K, Fu P, Zheng X, Yang H, Zhou Q, Ma W, Wang P. The Ability to Use Contextual Information in Object and Scene Recognition in Patients with Mild Cognitive Impairment. J Alzheimers Dis 2023; 95:945-963. [PMID: 37638431 DOI: 10.3233/jad-221132] [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: 08/29/2023]
Abstract
BACKGROUND The ability to understand and make use of object-scene relationships are critical for object and scene recognition. OBJECTIVE The current study assessed whether patients with mild cognitive impairment (MCI), possibly in the preclinical phase of Alzheimer's disease, exhibited impairment in processing contextual information in scene and object recognition. METHODS In Experiment 1, subjects viewed images of foreground objects in either semantic consistent or inconsistent scenes under no time pressure, and they verbally reported the names of foreground objects and backgrounds. Experiment 2 replicated Experiment 1, except that subjects were required to name scene first. Experiment 3 examined object and scene recognition accuracy baselines, recognition difficulty, familiarity with objects/scenes, and object-scene consistency judgements. RESULTS There were contextual consistency effects on scene recognition for MCI and healthy subjects, regardless of response sequence. Scenes were recognized more accurately under the consistent condition than the inconsistent condition. Additionally, MCI patients were more susceptible to incongruent contextual information, possibly due to inhibitory deficits or over-dependence on semantic knowledge. However, no significant differences between MCI and healthy subjects were observed in consistency judgement, recognition accuracy, recognition difficulty and familiarity rating, suggesting no significant impairment in object and scene knowledge among MCI subjects. CONCLUSIONS The study indicates that MCI patients retain relatively intact contextual processing ability but may exhibit inhibitory deficits or over-reliance on semantic knowledge.
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Affiliation(s)
- Yaqi Wang
- School of Foreign Languages and Literature, Shandong University, Jinan, China
- Center for Language Science, Shandong University, Jinan, China
| | - Kai Yang
- School of Foreign Languages and Literature, Shandong University, Jinan, China
| | - Pengrui Fu
- Department of Neurology, The Second Hospital of Shandong University, Jinan, China
| | - Xiaolei Zheng
- Department of Neurology, The Second Hospital of Shandong University, Jinan, China
| | - Hui Yang
- Department of Neurology, The Second Hospital of Shandong University, Jinan, China
| | - Qingbo Zhou
- Department of Neurology, The Second Hospital of Shandong University, Jinan, China
| | - Wen Ma
- School of Foreign Languages and Literature, Shandong University, Jinan, China
- Center for Language Science, Shandong University, Jinan, China
| | - Ping Wang
- Center for Language Science, Shandong University, Jinan, China
- Department of Neurology, The Second Hospital of Shandong University, Jinan, China
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Salzman T, Sarquis-Adamson Y, Son S, Montero-Odasso M, Fraser S. Associations of Multidomain Interventions With Improvements in Cognition in Mild Cognitive Impairment: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e226744. [PMID: 35503222 PMCID: PMC9066287 DOI: 10.1001/jamanetworkopen.2022.6744] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IMPORTANCE Older adults with mild cognitive impairment (MCI) have the highest risk of progressing to dementia. Evidence suggests that nonpharmacological, single-domain interventions can prevent or delay progressive declines, but it is unclear whether greater cognitive benefits arise from multidomain interventions. OBJECTIVE To determine whether multidomain interventions, composed of 2 or more interventions, are associated with greater improvements in cognition among older adults with MCI than a single intervention on its own. DATA SOURCES MEDLINE, Embase, PsycInfo, AgeLine, CINAHL, and Cochrane Central Register of Controlled Trials were systematically searched from database inception to December 20, 2021. STUDY SELECTION Included studies contained (1) an MCI diagnosis; (2) nonpharmacological, multidomain interventions that were compared with a single active control; (3) older adults aged 65 years and older; and (4) randomized clinical trials. DATA EXTRACTION AND SYNTHESIS Data were screened and extracted by 3 independent reviewers. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, random-effects meta-analyses were used to calculate effect sizes from the standardized mean difference (SMD) and 95% CIs. MAIN OUTCOMES AND MEASURES Postintervention cognitive test scores in 7 cognitive domains were compared between single-domain and multidomain groups. Exposure to the intervention was analyzed. RESULTS A total of 28 studies published between 2011 and 2021, including 2711 older adults with MCI, reported greater effect sizes in the multidomain group for global cognition (SMD, 0.41; 95% CI, 0.23-0.59; P < .001), executive function (SMD, 0.20; 95% CI, 0.04-0.36; P = .01), memory (SMD, 0.29; 95% CI, 0.14-0.45; P < .001), and verbal fluency (SMD, 0.30; 95% CI, 0.12-0.49; P = .001). The Mini-Mental State Examination (SMD, 0.40; 95% CI, 0.17-0.64; P < .001), category verbal fluency test (SMD, 0.34; 95% CI, 0.13-0.56; P = .002), Trail Making Test-B (SMD, 0.46; 95% CI, 0.13-0.80; P = .007), and Wechsler Memory Scale-Logical Memory I (SMD, 0.47; 95% CI, 0.15-0.80; P < .001) and II (SMD, 0.26; 95% CI, 0.07-0.45; P < .001) favored the multidomain group. Exposure to the intervention varied between studies: the mean (SD) duration was 71.3 (36.0) minutes for 19.8 (14.6) weeks with sessions taking place 2.5 (1.1) times per week, and all interventions lasted less than 1 year. CONCLUSIONS AND RELEVANCE In this study, short-term multidomain interventions (<1 year) were associated with improvements in global cognition, executive function, memory, and verbal fluency compared with single interventions in older adults with MCI.
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Affiliation(s)
- Talia Salzman
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ontario, Canada
| | - Yanina Sarquis-Adamson
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Surim Son
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Department of Medicine and Division of Geriatric Medicine, The University of Western Ontario, London, Ontario, Canada
| | - Sarah Fraser
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
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Orgeta V, Leung P, Del-Pino-Casado R, Qazi A, Orrell M, Spector AE, Methley AM. Psychological treatments for depression and anxiety in dementia and mild cognitive impairment. Cochrane Database Syst Rev 2022; 4:CD009125. [PMID: 35466396 PMCID: PMC9035877 DOI: 10.1002/14651858.cd009125.pub3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Experiencing anxiety and depression is very common in people living with dementia and mild cognitive impairment (MCI). There is uncertainty about the best treatment approach. Drug treatments may be ineffective and associated with adverse effects. Guidelines recommend psychological treatments. In this updated systematic review, we investigated the effectiveness of different psychological treatment approaches. OBJECTIVES Primary objective To assess the clinical effectiveness of psychological interventions in reducing depression and anxiety in people with dementia or MCI. Secondary objectives To determine whether psychological interventions improve individuals' quality of life, cognition, activities of daily living (ADL), and reduce behavioural and psychological symptoms of dementia, and whether they improve caregiver quality of life or reduce caregiver burden. SEARCH METHODS We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE, Embase, four other databases, and three trials registers on 18 February 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) that compared a psychological intervention for depression or anxiety with treatment as usual (TAU) or another control intervention in people with dementia or MCI. DATA COLLECTION AND ANALYSIS A minimum of two authors worked independently to select trials, extract data, and assess studies for risk of bias. We classified the included psychological interventions as cognitive behavioural therapies (cognitive behavioural therapy (CBT), behavioural activation (BA), problem-solving therapy (PST)); 'third-wave' therapies (such as mindfulness-based cognitive therapy (MBCT)); supportive and counselling therapies; and interpersonal therapies. We compared each class of intervention with control. We expressed treatment effects as standardised mean differences or risk ratios. Where possible, we pooled data using a fixed-effects model. We used GRADE methods to assess the certainty of the evidence behind each result. MAIN RESULTS We included 29 studies with 2599 participants. They were all published between 1997 and 2020. There were 15 trials of cognitive behavioural therapies (4 CBT, 8 BA, 3 PST), 11 trials of supportive and counselling therapies, three trials of MBCT, and one of interpersonal therapy. The comparison groups received either usual care, attention-control education, or enhanced usual care incorporating an active control condition that was not a specific psychological treatment. There were 24 trials of people with a diagnosis of dementia, and five trials of people with MCI. Most studies were conducted in community settings. We considered none of the studies to be at low risk of bias in all domains. Cognitive behavioural therapies (CBT, BA, PST) Cognitive behavioural therapies are probably slightly better than treatment as usual or active control conditions for reducing depressive symptoms (standardised mean difference (SMD) -0.23, 95% CI -0.37 to -0.10; 13 trials, 893 participants; moderate-certainty evidence). They may also increase rates of depression remission at the end of treatment (risk ratio (RR) 1.84, 95% CI 1.18 to 2.88; 2 studies, with one study contributing 2 independent comparisons, 146 participants; low-certainty evidence). We were very uncertain about the effect of cognitive behavioural therapies on anxiety at the end of treatment (SMD -0.03, 95% CI -0.36 to 0.30; 3 trials, 143 participants; very low-certainty evidence). Cognitive behavioural therapies probably improve patient quality of life (SMD 0.31, 95% CI 0.13 to 0.50; 7 trials, 459 participants; moderate-certainty evidence) and activities of daily living at end of treatment compared to treatment as usual or active control (SMD -0.25, 95% CI -0.40 to -0.09; 7 trials, 680 participants; moderate-certainty evidence). Supportive and counselling interventions Meta-analysis showed that supportive and counselling interventions may have little or no effect on depressive symptoms in people with dementia compared to usual care at end of treatment (SMD -0.05, 95% CI -0.18 to 0.07; 9 trials, 994 participants; low-certainty evidence). We were very uncertain about the effects of these treatments on anxiety, which was assessed only in one small pilot study. Other interventions There were very few data and very low-certainty evidence on MBCT and interpersonal therapy, so we were unable to draw any conclusions about the effectiveness of these interventions. AUTHORS' CONCLUSIONS CBT-based treatments added to usual care probably slightly reduce symptoms of depression for people with dementia and MCI and may increase rates of remission of depression. There may be important effect modifiers (degree of baseline depression, cognitive diagnosis, or content of the intervention). CBT-based treatments probably also have a small positive effect on quality of life and activities of daily living. Supportive and counselling interventions may not improve symptoms of depression in people with dementia. Effects of both types of treatment on anxiety symptoms are very uncertain. We are also uncertain about the effects of other types of psychological treatments, and about persistence of effects over time. To inform clinical guidelines, future studies should assess detailed components of these interventions and their implementation in different patient populations and in different settings.
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Affiliation(s)
- Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Phuong Leung
- Division of Psychiatry, University College London, London, UK
| | | | - Afifa Qazi
- Old Age Psychiatry, Kent and Medway NHS Partnership Trust, Maidstone, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Aimee E Spector
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Abigail M Methley
- Clinical Neuropsychology, Salford Royal NHS Foundation Trust, Salford, UK
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Arce Rentería M, Manly JJ, Vonk JM, Mejia Arango S, Michaels Obregon A, Samper-Ternent R, Wong R, Barral S, Tosto G. Midlife Vascular Factors and Prevalence of Mild Cognitive Impairment in Late-Life in Mexico. J Int Neuropsychol Soc 2022; 28:351-361. [PMID: 34376262 PMCID: PMC8831650 DOI: 10.1017/s1355617721000539] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To estimate the prevalence of mild cognitive impairment (MCI) and its subtypes and investigate the impact of midlife cardiovascular risk factors on late-life MCI among the aging Mexican population. METHOD Analyses included a sample of non-demented adults over the age of 55 living in both urban and rural areas of Mexico (N = 1807). MCI diagnosis was assigned based on a comprehensive cognitive assessment assessing the domains of memory, executive functioning, language, and visuospatial ability. The normative sample was selected by means of the robust norms approach. Cognitive impairment was defined by a 1.5-SD cut-off per cognitive domain using normative corrections for age, years of education, and sex. Risk factors included age, education, sex, rurality, depression, insurance status, workforce status, hypertension, diabetes, stroke, and heart disease. RESULTS The prevalence of amnestic MCI was 5.9%. Other MCI subtypes ranged from 4.2% to 7.7%. MCI with and without memory impairment was associated with older age (OR = 1.01 [1.01, 1.05]; OR = 1.03 [1.01, 1.04], respectively) and residing in rural areas (OR = 1.49 [1.08, 2.06]; OR = 1.35 [1.03, 1.77], respectively). Depression (OR = 1.07 [1.02, 1.12]), diabetes (OR = 1.37 [1.03, 1.82]), and years of education (OR = 0.94 [0.91, 0.97]) were associated with MCI without memory impairment. Midlife CVD increased the odds of MCI in late-life (OR = 1.76 [1.19, 2.59], which was driven by both midlife hypertension and diabetes (OR = 1.70 [1.18, 2.44]; OR = 1.88 [1.19, 2.97], respectively). CONCLUSIONS Older age, depression, low education, rurality, and midlife hypertension and diabetes were associated with higher risk of late-life MCI among older adults in Mexico. Our findings suggest that the causes of cognitive impairment are multifactorial and vary by MCI subtype.
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Affiliation(s)
- Miguel Arce Rentería
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Jet M.J. Vonk
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
- Julius Center for Health Sciences and Primary Care, Department of Epidemiology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Silvia Mejia Arango
- Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico
| | | | - Rafael Samper-Ternent
- Sealy Center on Aging, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Sandra Barral
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Giuseppe Tosto
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
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Lu K, Yong KXX, Skorupinska I, Deriziotis S, Collins JD, Henley SMD, Hanna MG, Rossor MN, Ridha BH, Machado PM. A cross-sectional study of memory and executive functions in patients with sporadic inclusion body myositis. Muscle Nerve 2022; 65:105-109. [PMID: 34605039 DOI: 10.1002/mus.27426] [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: 04/30/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION/AIMS Sporadic inclusion body myositis (IBM) is a degenerative and inflammatory acquired myopathy characterized by muscle deposition of various proteins typically associated with Alzheimer disease and other neurodegenerative diseases. Although cognitive impairment is not noted as a clinical feature of IBM, evidence is lacking. In this study we investigated whether cognitive performance of patients with IBM differs from population norms, focusing on cognitive domains affected in early Alzheimer disease (memory, executive function), and to test whether disease duration and the level of disability of IBM are associated with cognitive function. METHODS Twenty-four patients with IBM (mean [standard deviation]: age, 62.0 [7.2] years; disease duration, 9.6 [4.8] years) were assessed cross-sectionally on neuropsychological tests covering multiple cognitive domains, including the Preclinical Alzheimer Cognitive Composite (PACC). Performance was compared with published normative data adjusted for age, sex, and education (National Alzheimer's Coordinating Center; N = 3268). Associations were examined between PACC score, disease duration, and level of disability (assessed using the IBM Functional Rating Scale [IBMFRS]). RESULTS Across all cognitive tests, group performance was within ±1 standard deviation of the normative mean. There was no evidence of associations between PACC score and either disease duration (ρ = -0.04, P = .87) or IBMFRS total score (ρ = 0.14, P = .52). DISCUSSION Memory and executive function in patients with IBM did not differ from normative data, and we observed no evidence of associations between the cognitive composite and disease duration or level of disability. This addresses a question frequently asked by patients and will be of value for clinicians and patients alike.
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Affiliation(s)
- Kirsty Lu
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Iwona Skorupinska
- Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Foundation Trust, London, UK
| | - Stephanie Deriziotis
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Jessica D Collins
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Susie M D Henley
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Michael G Hanna
- Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Martin N Rossor
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Basil H Ridha
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Pedro M Machado
- Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, University College Hospitals NHS Foundation Trust, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
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Zou J, Park D, Johnson A, Feng X, Pardo M, France J, Tomljanovic Z, Brickman AM, Devanand DP, Luchsinger JA, Kreisl WC, Provenzano FA. Deep learning improves utility of tau PET in the study of Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12264. [PMID: 35005197 PMCID: PMC8719427 DOI: 10.1002/dad2.12264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Positron emission tomography (PET) imaging targeting neurofibrillary tau tangles is increasingly used in the study of Alzheimer's disease (AD), but its utility may be limited by conventional quantitative or qualitative evaluation techniques in earlier disease states. Convolutional neural networks (CNNs) are effective in learning spatial patterns for image classification. METHODS 18F-MK6240 (n = 320) and AV-1451 (n = 446) PET images were pooled from multiple studies. We performed iterations with differing permutations of radioligands, heuristics, and architectures. Performance was compared to a standard region of interest (ROI)-based approach on prediction of memory impairment. We visualized attention of the network to illustrate decision making. RESULTS Overall, models had high accuracy (> 80%) with good average sensitivity and specificity (75% and 82%, respectively), and had comparable or higher accuracy to the ROI standard. Visualizations of model attention highlight known characteristics of tau radioligand binding. DISCUSSION CNNs could improve tau PET's role in early disease and extend the utility of tau PET across generations of radioligands.
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Affiliation(s)
- James Zou
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
| | - David Park
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
| | - Aubrey Johnson
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
| | - Xinyang Feng
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
| | - Michelle Pardo
- Department of MedicineColumbia University Medical CenterNew YorkNew YorkUSA
| | - Jeanelle France
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
| | - Zeljko Tomljanovic
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
| | - Adam M. Brickman
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
- Department of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Devangere P. Devanand
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
- New York State Psychiatric Institute and Department of PsychiatryColumbia University Medical CenterNew YorkNew YorkUSA
| | - José A. Luchsinger
- Department of MedicineColumbia University Medical CenterNew YorkNew YorkUSA
- Department of EpidemiologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - William C. Kreisl
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
| | - Frank A. Provenzano
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainNew YorkNew YorkUSA
- Department of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
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Canfora F, Calabria E, Cuocolo R, Ugga L, Buono G, Marenzi G, Gasparro R, Pecoraro G, Aria M, D'Aniello L, Mignogna MD, Adamo D. Burning Fog: Cognitive Impairment in Burning Mouth Syndrome. Front Aging Neurosci 2021; 13:727417. [PMID: 34475821 PMCID: PMC8406777 DOI: 10.3389/fnagi.2021.727417] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/14/2021] [Indexed: 01/25/2023] Open
Abstract
Background: Due to its common association with chronic pain experience, cognitive impairment (CI) has never been evaluated in patients with burning mouth syndrome (BMS). The purpose of this study is to assess the prevalence of CI in patients with BMS and to evaluate its relationship with potential predictors such as pain, mood disorders, blood biomarkers, and white matter changes (WMCs). Methods: A case-control study was conducted by enrolling 40 patients with BMS and an equal number of healthy controls matched for age, gender, and education. Neurocognitive assessment [Mini Mental State Examination (MMSE), Digit Cancellation Test (DCT), the Forward and Backward Digit Span task (FDS and BDS), Corsi Block-Tapping Test (CB-TT), Rey Auditory Verbal Learning Test (RAVLT), Copying Geometric Drawings (CGD), Frontal Assessment Battery (FAB), and Trail Making A and B (TMT-A and TMT-B)], psychological assessment [Hamilton Rating Scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and 36-Item Short Form Health Survey (SF-36)], and pain assessment [Visual Analogic Scale (VAS), Total Pain Rating index (T-PRI), Brief Pain Inventory (BPI), and Pain DETECT Questionnaire (PD-Q)] were performed. In addition, blood biomarkers and MRI of the brain were recorded for the detection of Age-Related WMCs (ARWMCs). Descriptive statistics, the Mann-Whitney U-test, the Pearson Chi-Squared test and Spearman's correlation analysis were used. Results: Patients with BMS had impairments in most cognitive domains compared with controls (p < 0.001**) except in RAVLT and CGD. The HAM-D, HAM-A, PSQI, ESS, SF-36, VAS, T-PRI, BPI and PD-Q scores were statistically different between BMS patients and controls (p < 0.001**) the WMCs frequency and ARWMC scores in the right temporal (RT) and left temporal (LT) lobe were higher in patients with BMS (p = 0.023*). Conclusions: Meanwhile, BMS is associated with a higher decline in cognitive functions, particularly attention, working memory, and executive functions, but other functions such as praxis-constructive skills and verbal memory are preserved. The early identification of CI and associated factors may help clinicians to identify patients at risk of developing time-based neurodegenerative disorders, such as Alzheimer's disease (AD) and vascular dementia (VD), for planning the early, comprehensive, and multidisciplinary assessment and treatment.
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Affiliation(s)
- Federica Canfora
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Elena Calabria
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Buono
- Department of Diagnostical Morphological and Functional, University of Naples "Federico II", Naples, Italy
| | - Gaetano Marenzi
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Roberta Gasparro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Pecoraro
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University of Naples "Federico II", Naples, Italy
| | - Luca D'Aniello
- Department of Economics and Statistics, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Michele Davide Mignogna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
| | - Daniela Adamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples "Federico II", Naples, Italy
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Chang LH, Chen PY, Wang J, Shih BH, Tseng YH, Mao HF. High-Ecological Cognitive Intervention to Improve Cognitive Skills and Cognitive-Functional Performance for Older Adults With Mild Cognitive Impairment. Am J Occup Ther 2021; 75:14121. [PMID: 34780638 DOI: 10.5014/ajot.2021.041996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Evidence of the effectiveness of cognitive activity and preparatory tasks in improving the cognitive skills and functional performance of people with cognitive decline is limited. OBJECTIVE To examine the efficacy of a high-ecological cognitive intervention. DESIGN Quasi-experimental, pretest-posttest design with nonequivalent control. SETTING Community. PARTICIPANTS Older adults with mild cognitive impairment from two senior centers. INTERVENTION Twelve 90-min weekly group sessions of a high-ecological cognitive intervention using simulated everyday cognitive tasks (experimental group) and of nutrition education (active control group). Outcomes and Measures: Cognitive skills were measured with the Color Trails Test (CTT), the Contextual Memory Test (CMT; Immediate Recall [CMT-Im] and Delayed Recall [CMT-De] tasks), and the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span subtest (Digits Forward and Digits Backward). Cognitive-functional performance was measured with the Rivermead Behavioural Memory Test-Third Edition (RBMT-3; Immediate Recall [RBMT-3-Im] and Delayed Recall [RBMT-3-De] tasks) and the Cognitive Failures Questionnaire (CFQ). RESULTS Thirty-seven participants (M age = 70.84 yr; 70.3% women) met the inclusion criteria for analysis (20 participants in the intervention group, 17 participants in the control group). Multivariate linear regression showed that the intervention group improved significantly more than the control group on the CTT, CMT-Im, and RBMT-3-Im but not on the CMT-De, RBMT-3-De, and CFQ. CONCLUSIONS AND RELEVANCE Twelve 90-min weekly group sessions of a high-ecological cognitive intervention improved attention, executive function, immediate memory, and objective cognitive-functional performance with immediate-memory task demands. What This Article Adds: Carefully designed and structured simulated everyday cognitive tasks can be used as a cognitive training agent to improve both cognitive skills and objective cognitive-functional performance. The effectiveness of group-based cognitive interventions depends on the skills of occupational therapy practitioners in activity analysis and grading.
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Affiliation(s)
- Ling-Hui Chang
- Ling-Hui Chang, PhD, is Associate Professor, Department of Occupational Therapy and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Yen Chen
- Po-Yen Chen, MS, is Occupational Therapist, Department of Occupational Therapy, Jianan Psychiatric Center, Tainan, Taiwan
| | - Jye Wang
- Jye Wang, PhD, is Associate Professor, Department of Health Care Administration, Chang Jung Christian University, Tainan, Taiwan
| | - Bin-Huei Shih
- Bin-Huei Shih, MS, is Doctoral Student, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hsuan Tseng
- Yu-Hsuan Tseng, BS, is Graduate Student, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Fen Mao
- Hui-Fen Mao, MS, is Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;
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Rezaei M, Shariati B, Molloy DW, O’Caoimh R, Rashedi V. The Persian Version of the Quick Mild Cognitive Impairment Screen (Q mci-Pr): Psychometric Properties among Middle-Aged and Older Iranian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8582. [PMID: 34444331 PMCID: PMC8393250 DOI: 10.3390/ijerph18168582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 01/15/2023]
Abstract
Brief cognitive screening instruments are used to identify patients presenting with cognitive symptoms that warrant further assessment. This study aimed to evaluate the reliability and validity of the Persian version of the Quick Mild Cognitive Impairment (Qmci-Pr) among middle-aged and older Iranian adults. Consecutive patients aged ≥55 years and caregivers attending with them as normal controls (NCs) were recruited from geriatric outpatient clinics and a hospital in Tehran, Iran. All patients completed the Qmci-Pr before completing an independent detailed neuropsychological assessment and staging using the Clinical Dementia Rating (CDR) Scale. NCs underwent the same assessment. In all, 92 participants with a median age of 70 years (±13) were available. Of these, 20 participants were NCs, 24 had subjective memory complaints (SMC), 24 had mild cognitive impairment (MCI), and 24 had Alzheimer's disease (AD). The Qmci-Pr had good accuracy in differentiating SMC and NC from MCI (area under the curve (AUC): 0.80 (0.69-0.91)) and in identifying cognitive impairment (MCI and mild AD) (AUC: 0.87 (0.80-0.95)) with a sensitivity of 88% and specificity of 80%, at an optimal cut-off of <53/100. The Qmci-Pr is an accurate short cognitive screening impairment for separating NC and patients with SMC from MCI and identifying cognitive impairment. Further research with larger samples and comparison with other widely used instruments such as the Montreal Cognitive Assessment is needed. Given its established brevity, the Qmci-Pr is a useful screen for Iranian adults across the spectrum of cognitive decline.
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Affiliation(s)
- Mohammad Rezaei
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan 6517838687, Iran;
| | - Behnam Shariati
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran;
| | - David William Molloy
- Department of Geriatric Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland; (D.W.M.); (R.O.)
| | - Rónán O’Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland; (D.W.M.); (R.O.)
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran 1445613111, Iran
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17
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Brambilla M, Parra MA, Della Sala S, Alemanno F, Pomati S. Challenges to recruitment of participants with MCI in a multicentric neuropsychological study. Aging Clin Exp Res 2021; 33:2007-2010. [PMID: 33052589 DOI: 10.1007/s40520-020-01729-3] [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: 06/29/2020] [Accepted: 09/26/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Data on recruitment of Mild Cognitive Impairment (MCI) samples are seldom reported and this issue can be an important source of research waste. AIM To describe the recruitment challenges and reasons for non-eligibility faced during a bi-centre clinical study assessing the predictive value of a neuropsychological battery of the progression to dementia. METHODS Potential MCI participants were identified from databases of the two memory clinics based in Milan (Italy) and invited to the screening assessment. RESULTS About 50% of the cases initially identified were ineligible according to inclusion/exclusion criteria and the two sites took 22 months to recruit the planned 150 people. The main reasons for non-eligibility were the MMSE score (41%), age (14%), presence of cerebrovascular disorders (9%), perceptual deficits (6%), neurological (6%) or psychiatric (4%) comorbidities and low education (5%). CONCLUSION Awareness of the reasons for exclusion and of the time needed to recruit the planned sample would provide hints for the planning of future studies on MCI.
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Affiliation(s)
- Michela Brambilla
- Neurology Unit, Centre for the Treatment and Study of Cognitive Disorders, Luigi Sacco Hospital, Via Giovanni Battista Grassi 74, 20157, Milan, Italy
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK
| | - Federica Alemanno
- Department of Clinical Neuroscience, Specialistic Neurorehabilitation of Neurological, Cognitive and Motor Disorders, San Raffaele Scientific Institute, Milan, Italy
| | - Simone Pomati
- Neurology Unit, Centre for the Treatment and Study of Cognitive Disorders, Luigi Sacco Hospital, Via Giovanni Battista Grassi 74, 20157, Milan, Italy.
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18
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Papirovitz M, Gigi A. New Contemplation Upon Subjective Memory Complaints as a Self- Report Criterion for MCI Diagnosis. Curr Alzheimer Res 2021; 18:136-141. [PMID: 33882803 DOI: 10.2174/1567205018666210416095437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/21/2021] [Accepted: 04/05/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Subjective memory complaints are a key component in mild cognitive impairment (MCI) diagnosis. However, studies that examined memory awareness among MCI participants have published contradictory results. One possible explanation for the inconsistent findings could be the disregard from the multidimensional structure of subjective memory. OBJECTIVES The present study is directed at assessing subjective memory among healthy and MCI participants, referring to three main types of memory: episodic, semantic, and working memory. METHODS Participants were 123 adults (aged 50-90). They were divided into two groups, the MCI group, and the control group, according to their objective cognitive performance in RAVL or Mo- CA tests. All participants filled a subjective memory questionnaire, assessing their awareness of episodic, semantic, and working memory. RESULTS MCI participants estimated their semantic memory as significantly lower in comparison to the estimation of the healthy controls. By contrast, MCI participants showed an overestimation of their episodic memory capabilities compared to the control group. No significant difference was found between groups (MCI and healthy controls) in evaluating their working memory. In addition, for both groups, Pearson's correlation revealed a significant negative correlation between age and semantic memory evaluation. Such correlation was not found for subjective episodic memory. DISCUSSION Findings suggest that while people with MCI exhibit poor awareness of their episodic and working memory capabilities, their awareness of their decrease in semantic memory is apparently intact. Therefore, it is suggested that when using the self-report criterion for MCI diagnosis, clinicians should consider the patient's' semantic memory complaints.
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Affiliation(s)
- Merav Papirovitz
- Department of Psychology and Behavioral Sciences, Ariel University, Ariel 44837, Israel
| | - Ariela Gigi
- Department of Psychology and Behavioral Sciences, Ariel University, Ariel 44837, Israel
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Symonds AL, Macerollo A, Foy K, Alusi SH, Davies R. Genetic and Environmental Contributors to Neurodegeneration: An Exploration of the Effects of Alcohol on Clinical Features of Huntington's Disease Using the Enroll-HD Global Platform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105113. [PMID: 34065918 PMCID: PMC8151139 DOI: 10.3390/ijerph18105113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/06/2021] [Accepted: 05/08/2021] [Indexed: 11/29/2022]
Abstract
Huntington’s disease (HD) is a neurodegenerative dementia with a well recognised genetic cause. Alcohol misuse is a major environmental factor relevant to numerous neurological presentations, including HD. We explored the effects of alcohol intake on clinical features of HD by means of data from the Enroll-HD, which is a global registry study. A retrospective observational study making use of the Enroll-HD periodic dataset up to 2020 (in accordance with the Enroll-HD guidelines, encompassing 16,120 subjects with the HD gene (CAG expansion > 36), was carried out. This included 180 sites in 21 countries. The study looked at the association of alcohol use with the clinical presentation of HD, specifically looking into the age of first symptoms and HD severity. We also describe a specific case with manifest HD, a participant in the Enroll-HD study, whereby the patient’s obsessionality was central to her pattern of high alcohol intake and to her successful avoidance of alcohol thereafter. A record of past problems with high alcohol intake was more common in the group with manifest HD (9.0%, n = 1121) when compared with the pre-manifest carriers of the HD genetic abnormality (2.3%, n = 339). Age at onset of symptoms was not significantly influenced by current alcohol misuse, or past misuse. The severity of clinical impairments in HD was influenced by alcohol. Patients who reported high alcohol intake in the past had a statistically significant increase in motor impairments, by the Unified Huntington’s Disease Rating Scale total motor score (Kruskal–Wallis, post hoc Dunn’s, p < 0.001), and a significantly higher burden of psychiatric symptoms by the Problem Behaviours Assessment score (Kruskal–Wallis, post hoc Dunn’s, p < 0.01) compared with those not reporting high alcohol use. However, the past alcohol group did not have a lower Mini Mental State Examination score (Kruskal–Wallis, post hoc Dunn’s, p > 0.05) The first symptom of HD, as determined by the assessing clinician, was more likely to be psychiatric disturbance in patients currently misusing alcohol or those with prior history of alcohol misuse (55% and 31% respectively) when compared with controls (5%). Individual case experience, such as that presented in this study, shows that HD and alcohol, two major genetic and environmental contributors to neurodegeneration, interact in producing clinical problems. However, the complexities of these interactions are difficult to define, and may require larger studies dedicated to exploring the various factors in this interaction.
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Kim JH, Cho MR, Shin JC, Park GC, Lee JS. Factors contributing to cognitive improvement effects of acupuncture in patients with mild cognitive impairment: a pilot randomized controlled trial. Trials 2021; 22:341. [PMID: 33980288 PMCID: PMC8117619 DOI: 10.1186/s13063-021-05296-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 04/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background Mild cognitive impairment (MCI) is generally regarded as the borderline between cognitive changes of aging and very early Alzheimer’s disease (AD). It is important to develop easily available interventions to delay the progression of MCI to AD. We investigated factors contributing to the cognitive improvement effects of acupuncture to obtain data for developing optimized acupuncture treatments for MCI. Methods This outcome assessor-blinded, randomized controlled trial included a full analysis for comparing the efficacy of different acupuncture methods. Thirty-two participants with MCI (i.e., fulfilling the Peterson diagnostic criteria for MCI, K-MMSE scores of 20–23, and MoCA-K scale scores of 0–22) were randomly assigned to basic acupuncture (BA; GV20, EX-HN1, GB20, and GV24 for 30 min), acupoint specificity (AS; adding KI3 to BA), needle duration (ND; BA for 20 min), or electroacupuncture (EA; electrical stimulation to BA) groups (n=8/group) via 1:1:1:1 allocation and administered acupuncture once daily, three times a week for 8 weeks. The measured outcomes included scores on the Korean version of the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-K-cog), Korean version of the Montreal Cognitive Assessment scale (MoCA-K), Center for Epidemiological Studies-Depression Scale, Korean Activities of Daily Living scale, Korean Instrumental Activities of Daily Living scale, and European Quality of Life Five Dimension Five Level Scale. Outcome measurements were recorded at baseline (week 0), intervention endpoint (week 8), and 12 weeks after intervention completion (week 20). Results Twenty-five patients with MCI completed the trial (BA group, 8; AS group, 6; ND group, 5; EA group, 6). MoCA-K scores were significantly increased in the BA group compared with the ND (p=0.008, week 8–week 0) and EA groups (p=0.003, week 8–week 0; p=0.043, week 20–week 0). ADAS-K-cog scores were significantly decreased in the BA group compared with the ND group (p=0.019, week 20–week 0). Conclusions The BA group showed significant improvement in cognitive function compared to the ND and EA groups. Electrical stimulation and needle duration may contribute to the cognitive improvement effects of acupuncture in patients with MCI. Trial registration Clinical Research Information Service; URL:cris.nih.go.kr.; unique identifier: KCT0003430 (registration date: January 16, 2019). Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05296-4.
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Affiliation(s)
- Jae-Hong Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, DongShin University, Naju City, 58245, Republic of Korea. .,Department of Nursing, Christian College of Nursing, Gwangju City, 61662, Republic of Korea.
| | - Myoung-Rae Cho
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, DongShin University, Naju City, 58245, Republic of Korea
| | - Jeong-Cheol Shin
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, DongShin University, Naju City, 58245, Republic of Korea
| | - Gwang-Cheon Park
- Clinical Research Center, DongShin University Gwangju Korean Medicine Hospital, 141, Wolsan-ro, Nam-gu, Gwangju City, 61619, Republic of Korea
| | - Jeong-Soon Lee
- Department of Nursing, Christian College of Nursing, Gwangju City, 61662, Republic of Korea
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Yang SY, Lee HC, Huang CM, Chen JJ. Efficacy of Tai Chi-Style Multi-Component Exercise on Frontal-Related Cognition and Physical Health in Elderly With Amnestic Mild Cognitive Impairment. FRONTIERS IN AGING 2021; 2:636390. [PMID: 35822039 PMCID: PMC9261301 DOI: 10.3389/fragi.2021.636390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/17/2021] [Indexed: 02/06/2023]
Abstract
Early prevention from accelerated neurocognitive declines with advanced aging and the delay of the onset of dementia have became paramount for the achievement of active aging. The present study examined whether the proposed non-pharmaceutical, multi-component exercise training which combined Tai-Chi exercise, Aerobic fitness, and thera-band therapy protects against age-related neurocognitive and physical deterioration in the older participants with amnestic mild cognitive impairment (aMCI). Participants with aMCI in the quasi-experimental design were assigned to the multi-component exercise group or care control group. Evaluations of neuropsychological function and functional fitness were performed before and after 12-weeks intervention, and after 24-weeks follow-up. Our results showed that the multi-component intervention significantly improved various domains of neurocognitive function, particularly in memory- and frontal-related cognition, and better performance on functional fitness, including muscle strength, cardiopulmonary endurance, and agility. Furthermore, such beneficial effects were preserved after 24 weeks. The findings provide supportive evidence that non-pharmaceutically multi-component intervention with Tai-Chi style practice as a core exercise may protect against age-related neurocognitive and physical deficits and lay the path on developing age-friendly intervention programs to delay, or even reverse, the progression of MCI to dementia.
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Affiliation(s)
- Shao-Yun Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsuei-Chen Lee
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-devices (IDSB), National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- *Correspondence: Chih-Mao Huang, ; Jin-Jong Chen,
| | - Jin-Jong Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Sports and Health Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Innovation Center of Artificial Intelligence for Precision Exercise and Health Promotion, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- *Correspondence: Chih-Mao Huang, ; Jin-Jong Chen,
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22
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Junquera A, García-Zamora E, Olazarán J, Parra MA, Fernández-Guinea S. Role of Executive Functions in the Conversion from Mild Cognitive Impairment to Dementia. J Alzheimers Dis 2020; 77:641-653. [DOI: 10.3233/jad-200586] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Recent research pointed to executive dysfunction as a potential early predictor of the progression of mild cognitive impairment (MCI) to dementia in Alzheimer’s clinical syndrome (ACS). Such cognitive impairments account for functional impairments in instrumental activities of daily living (IADL). Objective: The present study analyzes the contributions of executive functions to predict MCI–dementia progression in ACS. Methods: We assessed 145 participants, 51 cognitively unimpaired and 94 MCI. The latter were divided using the traditional, memory-based MCI classification (single domain amnestic, multidomain amnestic, and non-amnestic). Eight tests assessing executive functions were administered at baseline and at 1-year follow-up, together with cognitive screening tools and IADL measures. MCI patients were reclassified based on the outcomes from a K-mean cluster analysis which identified three groups. A simple lineal regression model was used to examine whether the classification based on executive functioning could more accurately predict progression to dementia a year later. Results: Clusters based on executive function deficits explained a significant proportion of the variance linked to MCI–dementia conversion, even after controlling for the severity of MCI at baseline (F(1, 68) = 116.25, p = 0.000, R2 = 0.63). Classical memory-based MCI classification failed to predict such a conversion (F(1, 68) = 5.09, p = 0.955, R2 = 0.07). Switching, categories generation, and planning were the executive functions that best distinguished between MCI converters and stable. Conclusion: MCI with a dysexecutive phenotype significantly predicts conversion to dementia in ACS a year later. Switching abilities and verbal fluency (categories) must be evaluated in MCI patients to assess risk of future dementia.
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Affiliation(s)
- Almudena Junquera
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
| | - Estefanía García-Zamora
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
| | - Javier Olazarán
- Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
- Neuroprogressive and Dementia Network, NHS Scotland, UK
- Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Sara Fernández-Guinea
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
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23
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Hasselgren C, Ekbrand H, Halleröd B, Mellqvist Fässberg M, Zettergren A, Johansson L, Skoog I, Dellve L. Sex differences in dementia: on the potentially mediating effects of educational attainment and experiences of psychological distress. BMC Psychiatry 2020; 20:434. [PMID: 32887574 PMCID: PMC7487622 DOI: 10.1186/s12888-020-02820-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/13/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Old-age dementias are known to disproportionally affect women as well as individuals with low educational attainment. The higher lifetime risk of dementia among women is usually attributed to their longer life expectancy. However, the impact of sex, and subsequent gender inequity, is likely to be more multifaceted than this explanation implies. Not least because of historical inequities in access to education between the sexes and the gender and socio-economic gradients in risk factors such as stress, depression and social isolation. Consequently, the present study sought to test whether differences in educational attainment and experiences of general psychological distress mediate the association between female sex and dementia. METHODS The study utilizes data obtained through the Gothenburg H70 Birth Cohort Study and the Prospective Populations Study on Women (n = 892). Data were analysed using Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) with Weighted Least Squares Means and Variance adjusted (WLSMV) estimation. General psychological distress was indicated by a latent variable and constructed from five manifest items (previous depression, stress, self-esteem, chronic loneliness and satisfaction with social situation) that were all measured at baseline. RESULTS While the results could not corroborate that education directly mediates the effect of sex on dementia, level of distress was predicted by both female sex (0.607, p < .001) and education (- 0.166, p < .01) and, in turn, shown to be significantly associated with dementia (0.167, p < .05), also after controlling for confounders. When time from baseline to diagnosis was increased through sequential exclusion of dementia cases, the effect of distress on dementia was no longer significant. CONCLUSION The overall findings suggest that social (dis) advantage predicts general psychological distress, which thereby constitutes a potential, and rarely acknowledged, pathway between female sex, education, and dementia. They further underline the importance of attending to both education and distress as 'gendered' phenomena when considering the nature of their associations with dementia. However, the possibility of reverse causality bias must be acknowledged and the need for longitudinal studies with longer follow-up stressed.
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Affiliation(s)
- Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden.
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.
| | - Hans Ekbrand
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Madeleine Mellqvist Fässberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lena Johansson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lotta Dellve
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
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Steinbeisser K, Schwarzkopf L, Graessel E, Seidl H. Cost-effectiveness of a non-pharmacological treatment vs. "care as usual" in day care centers for community-dwelling older people with cognitive impairment: results from the German randomized controlled DeTaMAKS-trial. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:825-844. [PMID: 32219623 PMCID: PMC7366591 DOI: 10.1007/s10198-020-01175-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 02/11/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Cognitive impairment in older adults causes a high economic and societal burden. This study assesses the cost-effectiveness of the multicomponent, non-pharmacological MAKS treatment vs. "care as usual" in German day care centers (DCCs) for community-dwelling people with mild cognitive impairment (MCI) or mild to moderate dementia over 6 months. METHODS The analysis was conducted from the societal perspective alongside the cluster-randomized controlled, multicenter, prospective DeTaMAKS-trial with waitlist group design. Outcomes were Mini-Mental Status Examination (MMSE) and Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment (ETAM) of 433 individuals in 32 DCCs. Incremental differences in MMSE and ETAM were calculated via a Gaussian-distributed and incremental cost difference via a Gamma-distributed Generalized Linear Model. Cost-effectiveness was assessed via cost-effectiveness planes and cost-effectiveness acceptability curves (CEAC). RESULTS At 6 months, MMSE (adjusted mean difference = 0.92; 95% confidence interval (CI): 0.17 to 1.67; p = 0.02) and ETAM (adjusted mean difference = 1.00; CI: 0.14 to 1.85; p = 0.02) were significantly better in the intervention group. The adjusted cost difference was - €938.50 (CI: - 2733.65 to 763.13; p = 0.31). Given the CEAC, MAKS was cost-effective for 78.0% of MMSE and 77.4% for ETAM without a need for additional costs to payers. CONCLUSIONS MAKS is a cost-effective treatment to stabilize the ability to perform activities of daily living and cognitive abilities of people with MCI or mild to moderate dementia in German DCCs. Thus, MAKS should be implemented in DCCs.
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Affiliation(s)
- Kathrin Steinbeisser
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
| | - Larissa Schwarzkopf
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
- IFT Institut für Therapieforschung, Leopoldstr. 175, 80804 Munich, Germany
| | - Elmar Graessel
- Department of Psychiatry and Psychotherapy, Center for Health Service Research in Medicine, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Hildegard Seidl
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
- Quality Management and Gender Medicine, München Klinik gGmbH, München Klinik Schwabing, Kölner Platz 1, 80804 Munich, Germany
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25
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Pask S, Dell'Olio M, Murtagh FEM, Boland JW. The Effects of Opioids on Cognition in Older Adults With Cancer and Chronic Noncancer Pain: A Systematic Review. J Pain Symptom Manage 2020; 59:871-893.e1. [PMID: 31678462 DOI: 10.1016/j.jpainsymman.2019.10.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 01/08/2023]
Abstract
CONTEXT Opioids are prescribed to manage moderate-to-severe pain and can be used with older adults; however, they may lead to several adverse effects, including cognitive impairment. OBJECTIVES To identify, appraise, and synthesize evidence on the impact of opioids on cognition in older adults with cancer/chronic noncancer pain, and screening tools/neuropsychological assessments used to detect opioid-induced cognitive impairment. METHODS A systematic literature review following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (international prospective register of systematic reviews registration: CRD42018092943). MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library, and Web of Science were searched up to December 2018. Randomized controlled trials, quasi-experimental studies, and observational studies of adults aged 65 years and older with cancer/chronic noncancer pain taking opioids were included. A narrative synthesis was conducted. RESULTS From 4036 records, 10 met inclusion criteria. Five studies used one screening tool, and five studies used a range of neuropsychological assessments; assessing 14 cognitive domains. Most studies demonstrated no effect of opioid use on cognitive domains, whereas four studies showed mixed effects. In particular, attention, language, orientation, psychomotor function, and verbal working/delayed episodic memory were worsened. Changes to cognitive function were predominantly observed in studies with higher mean doses of opioids (120-190.7mg oral morphine equivalent daily dose). CONCLUSION Both improvements and impairments to cognition were observed in studies with higher mean opioid doses. In clinical practice, a brief screening tool assessing attention, language, orientation, psychomotor function, and verbal working/delayed episodic memory may be beneficial to detect worsening cognition in older adults with chronic pain using opioids.
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Affiliation(s)
- Sophie Pask
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom.
| | - Myriam Dell'Olio
- Academy of Primary Care, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Fliss E M Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Jason W Boland
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom
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Dalise AM, Prestano R, Fasano R, Gambardella A, Barbieri M, Rizzo MR. Autonomic Nervous System and Cognitive Impairment in Older Patients: Evidence From Long-Term Heart Rate Variability in Real-Life Setting. Front Aging Neurosci 2020; 12:40. [PMID: 32218729 PMCID: PMC7079686 DOI: 10.3389/fnagi.2020.00040] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/06/2020] [Indexed: 12/19/2022] Open
Abstract
Background: In geriatric age, cognitive impairment and cardiovascular disorders are frequent comorbidities. Age-related anatomical and functional cardiac changes, including the autonomic system, could interfere with the control of different cognitive domains. Therefore, we assess the relationship between long-term heart rate variability (HRV), as a measure of autonomic nervous system (ANS) functioning, and cognitive performance in elderly patients representative of outpatients in a real-life setting. Methods: Of 155 elderly outpatients (aged >65 years) screened, 117 enrolled patients underwent anthropometric evaluation, cardiac assessment by 12-lead electrocardiogram, 24-h ECG recording, and blood pressure (BP) measurement, as well as global cognitive evaluation by a standardized multidimensional assessment, including the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment test (MoCA). HRV analysis was performed on 24-h ECG recordings focusing on time-domain indices [Standard deviation of the NN intervals (SDNN), standard deviations of 5-min mean values of the NN intervals for each 5-min interval (SDANN), and root mean squares of successive differences of the NN intervals (RMSSD)] and on frequency-domain measurements [heart rate (HR), low frequency (LF), high frequency (HF), and LF/HF]. Multivariate linear analysis was used to explore the influence of the HRV significant variables on MMSE and MoCA test values. Results: The MMSE and MoCA scores were both significantly and positively correlated with the sympathetic system parameters (SDNN, SDANN, LF, and LF/HF ratio), but not with the parasympathetic system parameters (RMSSD and HF). Multivariate analysis confirms this relationship. Conclusions: Our results show that, in a representative real-life community elderly population, an increased sympathetic activity, but not decreased vagal activity, is associated with better cognitive performances. These results support the sympathetic autonomic function, in that the relationship between better cognitive performances and a moderate prevalence of autonomic function appears dependent on long-term changes in heart rate, mediated by sympathetic activation.
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Affiliation(s)
- Anna Maria Dalise
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Raffaele Prestano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renata Fasano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Gambardella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Requena C, Alvarez-Merino P, Rebok GW. Age- and education-adjusted normative data for the Rivermead Behavioural Memory Test (RBMT). Eur J Ageing 2019; 16:473-480. [PMID: 31798371 DOI: 10.1007/s10433-019-00514-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The original Rivermead Behavioural Memory Test (RBMT) suggests a cutoff global score of 10 points. However, this limit may be too stringent for older adults attending memory training programs, particularly for those with low education levels. This study aims to provide appropriately adjusted age and education norms for the RBMT. Data from 711 subjects were grouped based on age (65-67, 68-71, 72-75 and 76-83) and education level (primary school, high school and university studies). The data exhibit a clear trend of scores decreasing with age. The diminution in scores does not reach trend levels of significance between neighboring (< 5 years) age intervals, but it is statistically significant at the designated alpha level (p = .05) when younger and older adults are compared over a range of 5 years of difference. 81.86% of our sample has global scores below the suggested cutoff of 10 points. The present study provides a more accurate representation of RBMT global score performance in older adults for specific age and education stratifications.
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Affiliation(s)
- C Requena
- 1Department of Psychology, Sociology and Philosophy, University of León, Campus Vegazana, s/n, 24071 León, Spain
| | - P Alvarez-Merino
- 1Department of Psychology, Sociology and Philosophy, University of León, Campus Vegazana, s/n, 24071 León, Spain
| | - G W Rebok
- 2Department of Mental Health and Center on Aging and Health, Johns Hopkins University, 624 N. Broadway, Hampton House 833, Baltimore, MD 21205 USA
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Ho RTH, Fong TCT, Hon T, Chan WC, Kwan JSK, Chiu PKC, Lam LCW. Psychometric validation of Fuld Object Memory Evaluation in older adults with cognitive impairments. Aging Ment Health 2019. [PMID: 29517270 DOI: 10.1080/13607863.2018.1442414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) refers to an early but abnormal state of cognitive impairment with minimal functional impairment. The present study aimed to evaluate the validity of Fuld Object Memory Evaluation (FOME) as a measure of episodic memory function. METHOD The study sample included 204 Chinese older adults with cognitive impairments. The participants completed five recall trials and a delayed trial in FOME, neurocognitive measures on digit spans and trail making, and daily functioning. Discriminative power of FOME to differentiate between MCI and dementia was inspected via receiver operating characteristic curve analysis. RESULTS FOME showed good test-retest reliability and convergent validity with digit spans and trail making. Controlling for gender, age, and education, lower levels of FOME total retrieval, verbal fluency, and daily functioning significantly predicted a higher likelihood of dementia compared to MCI. The optimal cut-off scores for total retrieval, verbal fluency, and daily functioning to differentiate dementia were 37/38 (77% sensitivity and 83% specificity), 28/29 (85% sensitivity and 72% specificity), and 14/15 (92% sensitivity and 78% specificity), respectively, in the younger subgroup. The corresponding figures were 34/35 (69% sensitivity and 76% specificity) and 27/28 (92% sensitivity and 62% specificity), and 11/12 (74% sensitivity and 80% specificity), respectively, in the older subgroup. CONCLUSION The findings support the FOME as a valid assessment tool of episodic memory function in older Chinese adults. The combined use of FOME and daily functioning is recommended to distinguish persons with dementia from MCI.
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Affiliation(s)
- Rainbow T H Ho
- a Centre On Behavioral Health , The University of Hong Kong , Hong Kong.,b Department of Social Work & Social Administration , The University of Hong Kong , Hong Kong.,c Sau Po Centre on Aging , The University of Hong Kong , Hong Kong
| | - Ted C T Fong
- a Centre On Behavioral Health , The University of Hong Kong , Hong Kong.,b Department of Social Work & Social Administration , The University of Hong Kong , Hong Kong
| | - Tiffany Hon
- a Centre On Behavioral Health , The University of Hong Kong , Hong Kong
| | - Wai Chi Chan
- d Department of Psychiatry , The University of Hong Kong , Hong Kong
| | - Joseph S K Kwan
- e Department of Medicine , The University of Hong Kong , Hong Kong
| | - Patrick K C Chiu
- e Department of Medicine , The University of Hong Kong , Hong Kong
| | - Linda C W Lam
- f Department of Psychiatry , The Chinese University of Hong Kong , Hong Kong
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Gates NJ, Vernooij RWM, Di Nisio M, Karim S, March E, Martínez G, Rutjes AWS. Computerised cognitive training for preventing dementia in people with mild cognitive impairment. Cochrane Database Syst Rev 2019; 3:CD012279. [PMID: 30864747 PMCID: PMC6415132 DOI: 10.1002/14651858.cd012279.pub2] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The number of people living with dementia is increasing rapidly. Clinical dementia does not develop suddenly, but rather is preceded by a period of cognitive decline beyond normal age-related change. People at this intermediate stage between normal cognitive function and clinical dementia are often described as having mild cognitive impairment (MCI). Considerable research and clinical efforts have been directed toward finding disease-modifying interventions that may prevent or delay progression from MCI to clinical dementia. OBJECTIVES To evaluate the effects of at least 12 weeks of computerised cognitive training (CCT) on maintaining or improving cognitive function and preventing dementia in people with mild cognitive impairment. SEARCH METHODS We searched to 31 May 2018 in ALOIS (www.medicine.ox.ac.uk/alois) and ran additional searches in MEDLINE, Embase, PsycINFO, CINAHL, ClinicalTrials.gov, and the WHO portal/ICTRP (www.apps.who.int/trialsearch) to identify published, unpublished, and ongoing trials. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs in which cognitive training via interactive computerised technology was compared with an active or inactive control intervention. Experimental computerised cognitive training (CCT) interventions had to adhere to the following criteria: minimum intervention duration of 12 weeks; any form of interactive computerised cognitive training, including computer exercises, computer games, mobile devices, gaming console, and virtual reality. Participants were adults with a diagnosis of mild cognitive impairment (MCI) or mild neurocognitive disorder (MND), or otherwise at high risk of cognitive decline. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias of the included RCTs. We expressed treatment effects as mean differences (MDs) or standardised mean differences (SMDs) for continuous outcomes and as risk ratios (RRs) for dichotomous outcomes. We used the GRADE approach to describe the overall quality of evidence for each outcome. MAIN RESULTS Eight RCTs with a total of 660 participants met review inclusion criteria. Duration of the included trials varied from 12 weeks to 18 months. Only one trial used an inactive control. Most studies were at unclear or high risk of bias in several domains. Overall, our ability to draw conclusions was hampered by very low-quality evidence. Almost all results were very imprecise; there were also problems related to risk of bias, inconsistency between trials, and indirectness of the evidence.No trial provided data on incident dementia. For comparisons of CCT with both active and inactive controls, the quality of evidence on our other primary outcome of global cognitive function immediately after the intervention period was very low. Therefore, we were unable to draw any conclusions about this outcome.Due to very low quality of evidence, we were also unable to determine whether there was any effect of CCT compared to active control on our secondary outcomes of episodic memory, working memory, executive function, depression, functional performance, and mortality. We found low-quality evidence suggesting that there is probably no effect on speed of processing (SMD 0.20, 95% confidence interval (CI) -0.16 to 0.56; 2 studies; 119 participants), verbal fluency (SMD -0.16, 95% CI -0.76 to 0.44; 3 studies; 150 participants), or quality of life (mean difference (MD) 0.40, 95% CI -1.85 to 2.65; 1 study; 19 participants).When CCT was compared with inactive control, we obtained data on five secondary outcomes, including episodic memory, executive function, verbal fluency, depression, and functional performance. We found very low-quality evidence; therefore, we were unable to draw any conclusions about these outcomes. AUTHORS' CONCLUSIONS Currently available evidence does not allow us to determine whether or not computerised cognitive training will prevent clinical dementia or improve or maintain cognitive function in those who already have evidence of cognitive impairment. Small numbers of trials, small samples, risk of bias, inconsistency between trials, and highly imprecise results mean that it is not possible to derive any implications for clinical practice, despite some observed large effect sizes from individual studies. Direct adverse events are unlikely to occur, although the time and sometimes the money involved in computerised cognitive training programmes may represent significant burdens. Further research is necessary and should concentrate on improving methodological rigour, selecting suitable outcomes measures, and assessing generalisability and persistence of any effects. Trials with long-term follow-up are needed to determine the potential of this intervention to reduce the risk of dementia.
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Affiliation(s)
- Nicola J Gates
- University of New South WalesCentre for Healthy Brain Ageing (CHeBA)Suite 407 185 Elizabeth StreetSydneyAustralia2000
| | - Robin WM Vernooij
- Iberoamerican Cochrane CentreC/ Sant Antoni Maria Claret 167BarcelonaSpain08025
| | - Marcello Di Nisio
- University "G. D'Annunzio" of Chieti‐PescaraDepartment of Medicine and Ageing SciencesVia dei Vestini 31Chieti ScaloItaly66013
| | - Salman Karim
- Lancashire Care NHS Foundation TrustPsychiatrySceptre Point, Sceptre WayPrestonUKPR5 6AW
| | - Evrim March
- St Vincent's Hospital (Melbourne)St Vincent's Adult Mental Health46 Nicholson StreetFitzroyAustralia3065
| | - Gabriel Martínez
- Universidad de AntofagastaFaculty of Medicine and DentistryAvenida Argentina 2000AntofagastaChile127001
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Breton A, Casey D, Arnaoutoglou NA. Cognitive tests for the detection of mild cognitive impairment (MCI), the prodromal stage of dementia: Meta-analysis of diagnostic accuracy studies. Int J Geriatr Psychiatry 2019; 34:233-242. [PMID: 30370616 DOI: 10.1002/gps.5016] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/18/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is regarded as a prodrome to dementia. Various cognitive tests can help with diagnosis; meta-analysis of diagnostic accuracy studies would assist clinicians in choosing optimal tests. METHODS We searched online databases for "mild cognitive impairment" and "diagnosis" or "screening" from 01/01/1999 to 01/07/2017. Articles assessing the diagnostic accuracy of a cognitive test compared with standard diagnostic criteria were extracted. Risk of bias was assessed. Bivariate random-effects meta-analysis was used to evaluate sensitivity and specificity. RESULTS Eight cognitive tests (ACE-R, CERAD, CDT-Sunderland, IQCODE, Memory Alteration Test, MMSE, MoCA, and Qmci) were considered for meta-analysis. ACE-R, CERAD, MoCA, and Qmci were found to have similar diagnostic accuracy, while the MMSE had lower sensitivity. Memory Alteration Test had the highest sensitivity and equivalent specificity to the other tests. DISCUSSION Multiple cognitive tests have comparable diagnostic accuracy. The Memory Alteration Test is short and has the highest sensitivity. New cognitive tests for MCI diagnosis should not be compared with the MMSE.
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Affiliation(s)
- Alexandre Breton
- Medical School, Medical Sciences Division, University of Oxford, Oxford, UK
| | | | - Nikitas A Arnaoutoglou
- Department of Psychiatry, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
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Loprinzi PD, Blough J, Ryu S, Kang M. Experimental effects of exercise on memory function among mild cognitive impairment: systematic review and meta-analysis. PHYSICIAN SPORTSMED 2019; 47:21-26. [PMID: 30246596 DOI: 10.1080/00913847.2018.1527647] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the experimental effects of exercise on memory function among adults with mild cognitive impairment (MCI). METHODS A systematic review and meta-analysis were employed. Studies were identified using electronic databases, including PubMed, PsychInfo, SPORTDiscus, and Google Scholar. To be eligible for inclusion, studies had to employ an experimental design, be conducted in humans (no animal models) with mild cognitive impairment, include an exercise intervention arm (either acute exercise or chronic training), and measure memory function (any type) as the outcome measure. Comprehensive Meta-Analysis software was used to compute the standardized mean difference effect size (Cohen's d) and 95% CI using a random-effects model. RESULTS In total, 11 studies met our criteria, contributing to 20 effect size estimates. Among the 20 effect size estimates, 13 contributed to a short-term memory recall, with 7 contributing to a delayed/long-term memory recall. The overall weighted mean effect size was d = 0.30 (95% CI: 0.16-0.44; P < 0.001), indicating a small to medium effect of exercise on improving memory function. For the moderation analysis, there was no evidence of a moderation effect for recall duration (Q = 0.004, df(1), P = 0.95), as exercise (vs. control) demonstrated both short-term (d = 0.31; 95% CI: 0.14-0.47; P < 0.001) and long-term memory (d = 0.29; 95% CI: 0.06-0.53; P = 0.013) benefits. CONCLUSION Current evidence suggests that exercise may help to improve memory function among those with MCI. Safe and progressive forms of exercise should be promoted among MCI patients.
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Affiliation(s)
- Paul D Loprinzi
- a Exercise & Memory Laboratory, Department of Health, Exercise Science, and Recreation Management , University of Mississippi , Oxford , USA
| | - Jeremiah Blough
- b Health and Sport Analytics Laboratory, Department of Health, Exercise Science, and Recreation Management , University of Mississippi , Oxford , USA
| | - Seungho Ryu
- b Health and Sport Analytics Laboratory, Department of Health, Exercise Science, and Recreation Management , University of Mississippi , Oxford , USA
| | - Minsoo Kang
- b Health and Sport Analytics Laboratory, Department of Health, Exercise Science, and Recreation Management , University of Mississippi , Oxford , USA
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Rutjes AWS, Denton DA, Di Nisio M, Chong L, Abraham RP, Al‐Assaf AS, Anderson JL, Malik MA, Vernooij RWM, Martínez G, Tabet N, McCleery J. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. Cochrane Database Syst Rev 2018; 12:CD011906. [PMID: 30556597 PMCID: PMC6353240 DOI: 10.1002/14651858.cd011906.pub2] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamins and minerals play multiple functions within the central nervous system which may help to maintain brain health and optimal cognitive functioning. Supplementation of the diet with various vitamins and minerals has been suggested as a means of maintaining cognitive function, or even of preventing dementia, in later life. OBJECTIVES To evaluate the effects of vitamin and mineral supplementation on cognitive function in cognitively healthy people aged 40 years or more. SEARCH METHODS We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's (CDCIG) specialised register, as well as MEDLINE, Embase, PsycINFO, CINAHL, ClinicalTrials.gov and the WHO Portal/ICTRP from inception to 26th January 2018. SELECTION CRITERIA We included randomised controlled trials that evaluated the cognitive effects on people aged 40 years or more of any vitamin or mineral supplements taken by mouth for at least three months. DATA COLLECTION AND ANALYSIS Study selection, data extraction, and quality assessments were done in duplicate. Vitamins were considered broadly in the categories of B vitamins, antioxidant vitamins, and combinations of both. Minerals were considered separately, where possible. If interventions and outcomes were considered sufficiently similar, then data were pooled. In order to separate short-term cognitive effects from possible longer-term effects on the trajectory of cognitive decline, data were pooled for various treatment durations from 3 months to 12 months and up to 10 years or more. MAIN RESULTS In total, we included 28 studies with more than 83,000 participants. There were some general limitations of the evidence. Most participants were enrolled in studies which were not designed primarily to assess cognition. These studies often had no baseline cognitive assessment and used only brief cognitive assessments at follow-up. Very few studies assessed the incidence of dementia. Most study reports did not mention adverse events or made only very general statements about them. Only 10 studies had a mean follow-up > 5 years. Only two studies had participants whose mean age was < 60 years at baseline. The risk of bias in the included studies was generally low, other than a risk of attrition bias for longer-term outcomes. We considered the certainty of the evidence behind almost all results to be moderate or low.We included 14 studies with 27,882 participants which compared folic acid, vitamin B12, vitamin B6, or a combination of these to placebo. The majority of participants were aged over 60 years and had a history of cardio- or cerebrovascular disease. We found that giving B vitamin supplements to cognitively healthy adults, mainly in their 60s and 70s, probably has little or no effect on global cognitive function at any time point up to 5 years (SMD values from -0.03 to 0.06) and may also have no effect at 5-10 years (SMD -0.01). There were very sparse data on adverse effects or on incidence of cognitive impairment or dementia.We included 8 studies with 47,840 participants in which the active intervention was one or more of the antioxidant vitamins: ß-carotene, vitamin C or vitamin E. Results were mixed. For overall cognitive function, there was low-certainty evidence of benefit associated with ß-carotene after a mean of 18 years of treatment (MD 0.18 TICS points, 95% CI 0.01 to 0.35) and of vitamin C after 5 years to 10 years (MD 0.46 TICS points, 95% CI 0.14 to 0.78), but not at earlier time points. From two studies which reported on dementia incidence, there was low-certainty evidence of no effect of an antioxidant vitamin combination or of vitamin E, either alone or combined with selenium. One of the included studies had been designed to look for effects on the incidence of prostate cancer; it found a statistically significant increase in prostate cancer diagnoses among men taking vitamin E.One trial with 4143 participants compared vitamin D3 (400 IU/day) and calcium supplements to placebo. We found low- to moderate-certainty evidence of no effect of vitamin D3 and calcium supplements at any time-point up to 10 years on overall cognitive function (MD after a mean of 7.8 years -0.1 MMSE points, 95% CI -0.81 to 0.61) or the incidence of dementia (HR 0.94, 95% CI 0.72 to 1.24). A pilot study with 60 participants used a higher dose of vitamin D3 (4000 IU on alternate days) and found preliminary evidence that this dose probably has no effect on cognitive function over six months.We included data from one trial of zinc and copper supplementation with 1072 participants. There was moderate-certainty evidence of little or no effect on overall cognitive function (MD 0.6 MMSE points, 95% CI -0.19 to 1.39) or on the incidence of cognitive impairment after 5 years to 10 years. A second smaller trial provided no usable data, but reported no cognitive effects of six months of supplementation with zinc gluconate.From one study with 3711 participants, there was low-certainty evidence of no effect of approximately five years of selenium supplementation on the incidence of dementia (HR 0.83, 95% CI 0.61 to 1.13).Finally, we included three trials of complex supplements (combinations of B vitamins, antioxidant vitamins, and minerals) with 6306 participants. From the one trial which assessed overall cognitive function, there was low-certainty evidence of little or no effect on the TICS (MD after a mean of 8.5 years 0.12, 95% CI -0.14 to 0.38). AUTHORS' CONCLUSIONS We did not find evidence that any vitamin or mineral supplementation strategy for cognitively healthy adults in mid or late life has a meaningful effect on cognitive decline or dementia, although the evidence does not permit definitive conclusions. There were very few data on supplementation starting in midlife (< 60 years); studies designed to assess cognitive outcomes tended to be too short to assess maintenance of cognitive function; longer studies often had other primary outcomes and used cognitive measures which may have lacked sensitivity. The only positive signals of effect came from studies of long-term supplementation with antioxidant vitamins. These may be the most promising for further research.
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Affiliation(s)
- Anne WS Rutjes
- University of BernInstitute of Social and Preventive Medicine (ISPM)Mittelstrasse 43BernBernSwitzerland3012
- University of BernInstitute of Primary Health Care (BIHAM)Mittelstrasse 43BernBernSwitzerland3012
| | - David A Denton
- Sussex Partnership NHS Foundation TrustSpecialist Older People's ServicesUckfield Community HosptialFramfield RoadUckfieldUKTN22 5AW
| | - Marcello Di Nisio
- University "G. D'Annunzio" of Chieti‐PescaraDepartment of Medicine and Ageing SciencesVia dei Vestini 31Chieti ScaloItaly66013
| | | | - Rajesh P Abraham
- Surrey and Borders Partnership NHS Foundation TrustCommunity Mental Health Team for Older People:Waverley11‐13 Ockford RoadGuildfordUKGU7 1QU
| | - Aalya S Al‐Assaf
- Newcastle UniversityNIHR Innovation ObservatorySuite A, 4th Floor, Time CentralGallowgateNewcastle Upon TyneUKNE1 4BF
| | - John L Anderson
- Brighton and Sussex Medical School, University of BrightonDepartment of Medical EducationWatson BuildingFalmerUKBN1 9PH
| | - Muzaffar A Malik
- Brighton and Sussex Medical School, University of BrightonDepartment of Medical Education (Postgraduate)Room 341, Mayfield HouseFalmerUKBN1 9PH
| | - Robin WM Vernooij
- Iberoamerican Cochrane CentreC/ Sant Antoni Maria Claret 167BarcelonaBarcelonaSpain08025
| | - Gabriel Martínez
- Universidad de AntofagastaFaculty of Medicine and DentistryAvenida Argentina 2000AntofagastaChile127001
| | - Naji Tabet
- Brighton and Sussex Medical SchoolCentre for Dementia StudiesMayfield House, University of BrightonFalmerBrightonUKBN1 9PH
| | - Jenny McCleery
- Oxford Health NHS Foundation TrustElms CentreOxford RoadBanburyOxfordshireUKOX16 9AL
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McCleery J, Abraham RP, Denton DA, Rutjes AWS, Chong L, Al‐Assaf AS, Griffith DJ, Rafeeq S, Yaman H, Malik MA, Di Nisio M, Martínez G, Vernooij RWM, Tabet N. Vitamin and mineral supplementation for preventing dementia or delaying cognitive decline in people with mild cognitive impairment. Cochrane Database Syst Rev 2018; 11:CD011905. [PMID: 30383288 PMCID: PMC6378925 DOI: 10.1002/14651858.cd011905.pub2] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamins and minerals have many functions in the nervous system which are important for brain health. It has been suggested that various different vitamin and mineral supplements might be useful in maintaining cognitive function and delaying the onset of dementia. In this review, we sought to examine the evidence for this in people who already had mild cognitive impairment (MCI). OBJECTIVES To evaluate the effects of vitamin and mineral supplementation on cognitive function and the incidence of dementia in people with mild cognitive impairment. SEARCH METHODS We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's (CDCIG) specialised register, as well as MEDLINE, Embase, PsycINFO, CENTRAL, CINAHL, LILACs, Web of Science Core Collection, ClinicalTrials.gov, and the WHO Portal/ICTRP, from inception to 25 January 2018. SELECTION CRITERIA We included randomised or quasi-randomised, placebo-controlled trials which evaluated orally administered vitamin or mineral supplements in participants with a diagnosis of mild cognitive impairment and which assessed the incidence of dementia or cognitive outcomes, or both. We were interested in studies applicable to the general population of older people and therefore excluded studies in which participants had severe vitamin or mineral deficiencies. DATA COLLECTION AND ANALYSIS We sought data on our primary outcomes of dementia incidence and overall cognitive function and on secondary outcomes of episodic memory, executive function, speed of processing, quality of life, functional performance, clinical global impression, adverse events, and mortality. We conducted data collection and analysis according to standard Cochrane systematic review methods. We assessed the risk of bias of included studies using the Cochrane 'Risk of bias' assessment tool. We grouped vitamins and minerals according to their putative mechanism of action and, where we considered it to be clinically appropriate, we pooled data using random-effects methods. We used GRADE methods to assess the overall quality of evidence for each comparison and outcome. MAIN RESULTS We included five trials with 879 participants which investigated B vitamin supplements. In four trials, the intervention was a combination of vitamins B6, B12, and folic acid; in one, it was folic acid only. Doses varied. We considered there to be some risks of performance and attrition bias and of selective outcome reporting among these trials. Our primary efficacy outcomes were the incidence of dementia and scores on measures of overall cognitive function. None of the trials reported the incidence of dementia and the evidence on overall cognitive function was of very low-quality. There was probably little or no effect of B vitamins taken for six to 24 months on episodic memory, executive function, speed of processing, or quality of life. The evidence on our other secondary clinical outcomes, including harms, was very sparse or very low-quality. There was evidence from one study that there may be a slower rate of brain atrophy over two years in participants taking B vitamins. The same study reported subgroup analyses based on the level of serum homocysteine (tHcy) at baseline and found evidence that B vitamins may improve episodic memory in those with tHcy above the median at baseline.We included one trial (n = 516) of vitamin E supplementation. Vitamin E was given as 1000 IU of alpha-tocopherol twice daily. We considered this trial to be at risk of attrition and selective reporting bias. There was probably no effect of vitamin E on the probability of progression from MCI to Alzheimer's dementia over three years (HR 1.02; 95% CI 0.74 to 1.41; n = 516; 1 study, moderate-quality evidence). There was also no evidence of an effect at intermediate time points. The available data did not allow us to conduct analyses, but the authors reported no significant effect of three years of supplementation with vitamin E on overall cognitive function, episodic memory, speed of processing, clinical global impression, functional performance, adverse events, or mortality (five deaths in each group). We considered this to be low-quality evidence.We included one trial (n = 256) of combined vitamin E and vitamin C supplementation and one trial (n = 26) of supplementation with chromium picolinate. In both cases, there was a single eligible cognitive outcome, but we considered the evidence to be very low-quality and so could not be sure of any effects. AUTHORS' CONCLUSIONS The evidence on vitamin and mineral supplements as treatments for MCI is very limited. Three years of treatment with high-dose vitamin E probably does not reduce the risk of progression to dementia, but we have no data on this outcome for other supplements. Only B vitamins have been assessed in more than one RCT. There is no evidence for beneficial effects on cognition of supplementation with B vitamins for six to 24 months. Evidence from a single study of a reduced rate of brain atrophy in participants taking vitamin B and a beneficial effect of vitamin B on episodic memory in those with higher tHcy at baseline warrants attempted replication.
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Affiliation(s)
- Jenny McCleery
- Oxford Health NHS Foundation TrustElms CentreOxford RoadBanburyOxfordshireUKOX16 9AL
| | - Rajesh P Abraham
- Surrey and Borders Partnership NHS Foundation TrustCommunity Mental Health Team for Older People:Waverley11‐13 Ockford RoadGuildfordUKGU7 1QU
| | - David A Denton
- Sussex Partnership NHS Foundation TrustSpecialist Older People's ServicesUckfield Community HosptialFramfield RoadUckfieldUKTN22 5AW
| | - Anne WS Rutjes
- Fondazione "Università G. D'Annunzio"Centre for Systematic ReviewsVia dei Vestini 31ChietiChietiItaly66100
- University of BernInstitute of Social and Preventive Medicine (ISPM)Mittelstrasse 43BernBernSwitzerland3012
| | | | - Aalya S Al‐Assaf
- Newcastle UniversityNIHR Innovation ObservatorySuite A, 4th Floor, Time CentralGallowgateNewcastle Upon TyneUKNE1 4BF
| | - Daniel J Griffith
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation TrustDepartment of Nutrition and DieteticsMindelsohn WayEdgbastonBirminghamWest MidlandsUKB15 2GW
| | - Shireen Rafeeq
- Central Park Medical CollegeCommunity MedicineCentral Park Housing Scheme, Ferozepur Road, Kahna NauLahorePunjabPakistan53100
| | - Hakan Yaman
- Faculty of Medicine, Akdeniz UniversityDepartment of Family MedicineAntalyaTurkey07059
| | - Muzaffar A Malik
- Brighton and Sussex Medical School, University of BrightonDepartment of Medical Education (Postgraduate)Room 341, Mayfield HouseFalmerUKBN1 9PH
| | - Marcello Di Nisio
- University "G. D'Annunzio" of Chieti‐PescaraDepartment of Medicine and Ageing SciencesVia dei Vestini 31Chieti ScaloItaly66013
| | - Gabriel Martínez
- Universidad de AntofagastaFaculty of Medicine and DentistryAvenida Argentina 2000AntofagastaChile127001
- Iberoamerican Cochrane CentreSant Antoni Maria Claret 167BarcelonaSpain08025
| | - Robin WM Vernooij
- Iberoamerican Cochrane CentreSant Antoni Maria Claret 167BarcelonaSpain08025
| | - Naji Tabet
- Brighton and Sussex Medical SchoolCentre for Dementia StudiesMayfield House, University of BrightonFalmerBrightonUKBN1 9PH
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Oltra-Cucarella J, Delgado S, Duque P, Pérez-Vicente JA, Cabello-Rodríguez L. Encoding deficits in low-educated individuals with non-amnestic Mild Cognitive Impairment. Analysis of memory processes using the Item Specific Deficit Approach. Psychiatry Res 2018; 268:211-216. [PMID: 30059887 DOI: 10.1016/j.psychres.2018.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 06/19/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
This work aims to analyze encoding impairments using new assessment scores in patients with naMCI who present to memory clinics with subjective cognitive complaints. The sample included 102 participants, of whom 28 were classified as healthy controls (HC), 24 as amnestic MCI (aMCI), 24 as naMCI and 26 patients as Alzheimer's disease (AD). Research outcomes were the Encoding, Consolidation and Retrieval deficit indices from the Item Specific Deficit Approach, and traditional indices (immediate total recall, delayed cued recall, delayed total recall) derived from the Free and Cued Selective Reminding Test (FCSRT). We found no differences in immediate recall or delayed recall between HC and naMCI on the FCSRT, both scoring higher than aMCI and AD. naMCI showed encoding deficits in between HC and aMCI, with no differences between naMCI and HC on consolidation or retrieval deficit indices. The ISDA indices were better than traditional indices to discriminate between HC and naMCI (sensitivity: 70.8%, specificity: 78.6%), whereas the opposite pattern was found between naMCI and aMCI (sensitivity: 70.8%, specificity: 91.7%). New indices derived from neuropsychological tests may help to identify objective memory impairments in naMCI. Whether these new indices are useful for predicting conversion to AD needs further research.
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Affiliation(s)
- Javier Oltra-Cucarella
- Unit of Cognitive Impairments and Movement Disorders, Service of Neurology, Hospital Universitario Santa María del Rosell, Paseo Alfonso XIII, 61 30203, Cartagena, Murcia, Spain.
| | | | - Pablo Duque
- Research Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain; INEURO® project, Sevilla, Spain
| | - José Antonio Pérez-Vicente
- Unit of Cognitive Impairments and Movement Disorders, Service of Neurology, Hospital Universitario Santa María del Rosell, Paseo Alfonso XIII, 61 30203, Cartagena, Murcia, Spain
| | - Luís Cabello-Rodríguez
- Unit of Cognitive Impairments and Movement Disorders, Service of Neurology, Hospital Universitario Santa María del Rosell, Paseo Alfonso XIII, 61 30203, Cartagena, Murcia, Spain
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Bessi V, Mazzeo S, Padiglioni S, Piccini C, Nacmias B, Sorbi S, Bracco L. From Subjective Cognitive Decline to Alzheimer’s Disease: The Predictive Role of Neuropsychological Assessment, Personality Traits, and Cognitive Reserve. A 7-Year Follow-Up Study. J Alzheimers Dis 2018; 63:1523-1535. [DOI: 10.3233/jad-171180] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Salvatore Mazzeo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Sonia Padiglioni
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- IRCCS Don Carlo Gnocchi, Florence, Italy
| | - Laura Bracco
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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Delaney A, Tamás PA. Searching for evidence or approval? A commentary on database search in systematic reviews and alternative information retrieval methodologies. Res Synth Methods 2017; 9:124-131. [DOI: 10.1002/jrsm.1282] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 08/20/2017] [Accepted: 10/23/2017] [Indexed: 11/09/2022]
Affiliation(s)
| | - Peter A. Tamás
- Biometris; Wageningen University; Wageningen The Netherlands
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Sex differences in the prevalence and incidence of mild cognitive impairment: A meta-analysis. Ageing Res Rev 2017; 35:176-199. [PMID: 27771474 DOI: 10.1016/j.arr.2016.09.005] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/31/2016] [Accepted: 09/26/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE More women have Alzheimer's disease (AD) than men. Understanding sex differences in mild cognitive impairment (MCI) may further knowledge of AD etiology and prevention. We conducted a meta-analysis to examine sex differences in the prevalence and incidence of MCI, which included amnestic and non-amnestic subtypes. METHOD Systematic searches were performed in July 2015 using MEDLINE/PubMed, Scopus, and PsycINFO for population-or community-based studies with MCI data for men and women. Random-effects model were used. RESULTS Fifty-six studies were included. There were no statistically significant sex differences in prevalence or incidence of amnestic MCI. There was a significantly higher prevalence (p=0.038), but not incidence, of non-amnestic MCI among women. There were no sex differences in studies that combined both subtypes of MCI. CONCLUSION The only statistically significant finding emerging from this study was that women have a higher prevalence of non-amnestic MCI. To better understand sex differences in the preclinical stages of dementia, studies must better characterize the etiology of the cognitive impairment.
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Rodgers JE, Thudium EM, Beyhaghi H, Sueta CA, Alburikan KA, Kucharska-Newton AM, Chang PP, Stearns SC. Predictors of Medication Adherence in the Elderly: The Role of Mental Health. Med Care Res Rev 2017; 75:746-761. [PMID: 29148336 DOI: 10.1177/1077558717696992] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aging population routinely has comorbid conditions requiring complicated medication regimens, yet nonadherence can preclude optimal outcomes. This study explored the association of adherence in the elderly with demographic, socioeconomic, and disease burden measures. Data were from the fifth visit (2011-2013) for 6,538 participants in the Atherosclerosis Risk in Communities Study, conducted in four communities. The Morisky-Green-Levine Scale measured self-reported adherence. Forty percent of respondents indicated some nonadherence, primarily due to poor memory. Logit regression showed, surprisingly, that persons with low reading ability were more likely to report being adherent. Better self-reported physical or mental health both predicted better adherence, but the magnitude of the association was greater for mental than for physical health. Compared with persons with normal or severely impaired cognition, mild cognitive impairment was associated with lower adherence. Attention to mental health measures in clinical settings could provide opportunities for improving medication adherence.
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Affiliation(s)
- Jo E Rodgers
- 1 Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, NC, USA
| | - Emily M Thudium
- 1 Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, NC, USA
| | - Hadi Beyhaghi
- 2 Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
| | - Carla A Sueta
- 3 School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
| | - Khalid A Alburikan
- 4 College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Anna M Kucharska-Newton
- 2 Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
| | - Patricia P Chang
- 3 School of Medicine, The University of North Carolina at Chapel Hill, NC, USA
| | - Sally C Stearns
- 2 Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, NC, USA
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Jiang S, Yan C, Qiao Z, Yao H, Jiang S, Qiu X, Yang X, Fang D, Yang Y, Zhang L, Wang L, Zhang L. Mismatch negativity as a potential neurobiological marker of early-stage Alzheimer disease and vascular dementia. Neurosci Lett 2017; 647:26-31. [PMID: 28336337 DOI: 10.1016/j.neulet.2017.03.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/05/2017] [Accepted: 03/17/2017] [Indexed: 12/30/2022]
Abstract
Alzheimer's disease (AD) and vascular dementia (VD) are serious, irreversible forms of cognitive impairment, which means that an early diagnosis is essential to slow down their progression. One potential neurophysiological biomarker of these diseases is the mismatch negativity (MMN) event-related potentials (ERP) component, which reflects an automatic detection mechanism at the pre-attentive stages of information processing. We evaluated the auditory MMN response in individuals from two patient groups: those in the prodromal stages of AD (P-AD) and those in the prodromal stages of VD (P-VD). Thirty patients (15 P-AD patients and 15 P-VD patients) and 30 age-matched controls were recruited to undergo electrophysiological recordings during the presentation of an auditory deviant-standard-reverse oddball paradigm that was used to elicit genuine MMN responses. We show that over the frontal-central area, the mean amplitude of the MMN was significantly reduced in both the P-AD (p=0.017) and P-VD groups (p=0.013) compared with controls. The MMN peak latency in P-VD patients was significantly shorter than in controls (p=0.027). No MMN response differences between the P-AD and P-VD were found in either the frontal-central or the temporal areas. These results indicate that P-AD and P-VD patients exhibit impaired pre-attentive information processing mechanisms as revealed by the frontal-central area MMN response, which is associated with sensory memory and cognitive deficits.
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Affiliation(s)
- Shixiang Jiang
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang, China; Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Chang Yan
- Department of Pathophysiology, School of Basic Medical Sciences, Harbin Medical University, Heilongjiang, China
| | - Zhengxue Qiao
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang, China
| | - Haiqian Yao
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Shiquan Jiang
- Department of pain, Harbin Tiantai Hospital, Harbin, Heilongjiang, China
| | - Xiaohui Qiu
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang, China
| | - Xiuxian Yang
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang, China
| | | | - Yanjie Yang
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang, China.
| | - Limei Zhang
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China.
| | - Lina Wang
- Department of Pathophysiology, School of Basic Medical Sciences, Harbin Medical University, Heilongjiang, China.
| | - Liming Zhang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, China.
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Farooqui Z, Bakulski KM, Power MC, Weisskopf MG, Sparrow D, Spiro A, Vokonas PS, Nie LH, Hu H, Park SK. Associations of cumulative Pb exposure and longitudinal changes in Mini-Mental Status Exam scores, global cognition and domains of cognition: The VA Normative Aging Study. ENVIRONMENTAL RESEARCH 2017; 152:102-108. [PMID: 27770710 PMCID: PMC5135609 DOI: 10.1016/j.envres.2016.10.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/23/2016] [Accepted: 10/11/2016] [Indexed: 05/16/2023]
Abstract
BACKGROUND Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. METHODS In a 1993-2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. RESULTS Among men 51-98 at baseline, higher patella Pb concentration (IQR: 21μg/g) was associated with -0.13 lower baseline MMSE (95% CI: -0.25, -0.004) and faster longitudinal MMSE decline (-0.016 units/year, 95% CI: -0.032, -0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: -0.026, -0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: -0.027, -0.002). We found weaker associations with tibia Pb. CONCLUSIONS Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging.
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Affiliation(s)
- Zishaan Farooqui
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kelly M Bakulski
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Melinda C Power
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute of Public Health, Washington, DC, USA
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David Sparrow
- VA Normative Aging Study, Veterans Affairs Boston Health Care System, Boston, MA, USA; Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Avron Spiro
- VA Normative Aging Study, Veterans Affairs Boston Health Care System, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Pantel S Vokonas
- VA Normative Aging Study, Veterans Affairs Boston Health Care System, Boston, MA, USA; Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Linda H Nie
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Howard Hu
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sung Kyun Park
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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Mazzeo S, Santangelo R, Bernasconi MP, Cecchetti G, Fiorino A, Pinto P, Passerini G, Falautano M, Comi G, Magnani G. Combining Cerebrospinal Fluid Biomarkers and Neuropsychological Assessment: A Simple and Cost-Effective Algorithm to Predict the Progression from Mild Cognitive Impairment to Alzheimer’s Disease Dementia. J Alzheimers Dis 2016; 54:1495-1508. [DOI: 10.3233/jad-160360] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Salvatore Mazzeo
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Roberto Santangelo
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Maria Paola Bernasconi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giordano Cecchetti
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Agnese Fiorino
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Patrizia Pinto
- Department of Neurology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Monica Falautano
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
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Gates NJ, Karim S, Rutjes AWS, Ware J, Chong LY, March E, Vernooij RWM. Computerised cognition-based interventions for maintaining cognitive function in cognitively healthy people in late life. Hippokratia 2016. [DOI: 10.1002/14651858.cd012277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nicola J Gates
- University of New South Wales; Centre for Healthy Brain Ageing (CHeBA); Suite 407 185 Elizabeth Street Sydney NSW Australia 2000
| | - Salman Karim
- Lancashire Care NHS Foundation Trust; Memory Assessment Service; Charnley Fold, Cottage Lane Preston UK PR5 6YA
| | - Anne WS Rutjes
- Fondazione "Università G. D'Annunzio"; Centre for Systematic Reviews; Via dei Vestini 31 Chieti Chieti Italy 66100
- University of Bern; CTU Bern; Bern Bern Switzerland 3012
- University of Bern; Institute of Social and Preventive Medicine (ISPM); Finkenhubelweg 11 Bern Bern Switzerland 3012
| | - Jennifer Ware
- University of Oxford; Cochrane Dementia and Cognitive Improvement Group; Oxford UK OX3 9DU
| | | | - Evrim March
- St Vincent's Hospital (Melbourne); St Vincent's Adult Mental Health; 46 Nicholson Street Fitzroy VIC Australia 3065
| | - Robin WM Vernooij
- Iberoamerican Cochrane Centre; C/ Sant Antoni Maria Claret 167 Barcelona Barcelona Spain 08025
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43
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Gates NJ, Karim S, Rutjes AWS, Ware J, March E, Vernooij RWM. Computerised cognition-based interventions for preventing dementia in people with mild cognitive impairment. Hippokratia 2016. [DOI: 10.1002/14651858.cd012279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Nicola J Gates
- University of New South Wales; Centre for Healthy Brain Ageing (CHeBA); Suite 407 185 Elizabeth Street Sydney NSW Australia 2000
| | - Salman Karim
- Lancashire Care NHS Foundation Trust; Memory Assessment Service; Charnley Fold, Cottage Lane Preston UK PR5 6YA
| | - Anne WS Rutjes
- Fondazione "Università G. D'Annunzio"; Centre for Systematic Reviews; Via dei Vestini 31 Chieti Chieti Italy 66100
- University of Bern; CTU Bern; Bern Bern Switzerland 3012
- University of Bern; Institute of Social and Preventive Medicine (ISPM); Finkenhubelweg 11 Bern Bern Switzerland 3012
| | - Jennifer Ware
- University of Oxford; Cochrane Dementia and Cognitive Improvement Group; Oxford UK OX3 9DU
| | - Evrim March
- St Vincent's Hospital (Melbourne); St Vincent's Adult Mental Health; 46 Nicholson Street Fitzroy VIC Australia 3065
| | - Robin WM Vernooij
- Iberoamerican Cochrane Centre; C/ Sant Antoni Maria Claret 167 Barcelona Barcelona Spain 08025
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44
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Johnson LA, Gamboa A, Vintimilla R, Cheatwood AJ, Grant A, Trivedi A, Edwards M, Hall JR, O'Bryant SE. Comorbid Depression and Diabetes as a Risk for Mild Cognitive Impairment and Alzheimer's Disease in Elderly Mexican Americans. J Alzheimers Dis 2016; 47:129-36. [PMID: 26402761 DOI: 10.3233/jad-142907] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND The links between diabetes, depression, and Alzheimer's disease (AD) has been established, but they are still poorly understood. However, little research has examined the effect that comorbidity of depression and diabetes has on cognitive impairment in an ethnically diverse sample. OBJECTIVE The purpose of this study was to investigate the relationship between comorbid diabetes and depression on cognitive dysfunction; and examine the relationship in an ethnically diverse population. METHODS AND RESULTS Analyses of data from 2,436 participants (914 men and 1,522 women) of three separate cohorts: HABLE, FRONTIER, and TARCC. In the HABLE cohort, comorbidity (odds ratio [OR] = 3.008; 95% CI = 1.358-6.667), age (OR = 1.138; 95% CI = 1.093-1.185), and education (OR = 0.915; 95% CI = 0.852-0.982) increased the risk of mild cognitive impairment (MCI) diagnosis among elderly Mexican American. In the TARCC cohort, results showed an increase risk of MCI in both non-Hispanic whites (OR = 18.795; 95% CI = 2.229-158.485) and Mexican Americans (OR = 8.417; 95% CI = 2.967-23.878). Finally, results in the FRONTIER cohort showed that in elderly Mexican Americans, comorbidity (OR = 2.754; 95% CI = 1.084-6.995) and age (OR = 1.069; 95% CI = 1.023-1.118) significantly increased risk of MCI. In non-Hispanic whites, comorbidity did not significantly increase risk of MCI. CONCLUSIONS Among elderly Mexican Americans, comorbid depression and diabetes significantly increased risk for MCI and AD across cohorts. Effects of comorbid diabetes and depression on MCI were inconclusive. Our results support the link between comorbid diabetes and depression and risk for cognitive decline among Mexican Americans. This finding is of critical importance as the Hispanic population is at higher risk of developing AD.
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Affiliation(s)
- Leigh A Johnson
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA.,Institute for Aging & Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Adriana Gamboa
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Raul Vintimilla
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | | | | | - Melissa Edwards
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - James R Hall
- Institute for Aging & Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, TX, USA.,Department of Psychiatry, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Sid E O'Bryant
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA.,Institute for Aging & Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, TX, USA
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45
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Self-awareness in Mild Cognitive Impairment: Quantitative evidence from systematic review and meta-analysis. Neurosci Biobehav Rev 2016; 61:90-107. [DOI: 10.1016/j.neubiorev.2015.10.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 10/11/2015] [Accepted: 10/12/2015] [Indexed: 12/20/2022]
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46
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Yang EJ, Cai M, Lee JH. Neuroprotective Effects of Electroacupuncture on an Animal Model of Bilateral Common Carotid Artery Occlusion. Mol Neurobiol 2015; 53:7228-7236. [PMID: 26687230 DOI: 10.1007/s12035-015-9610-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 12/03/2015] [Indexed: 11/30/2022]
Abstract
Mild cognitive impairment (MCI) is considered as an intermediate zone between normal aging and dementia. The most prominent feature of MCI is an isolated mild decline in memory, whereas other cognitive functions remain intact. The symptoms of vascular cognitive impairment (VCI) range from MCI to dementia, and an animal model of VCI has been established in a gerbil by transient bilateral common carotid artery occlusion (BCCAO). In the current study, we set out to investigate whether electroacupuncture (EA) could improve memory in gerbils with BCCAO-induced MCI. Animals were randomly divided into two groups: sham-operated group (n = 17) and a model group that was subdivided into BCCAO, n = 17, and EA-treated BCCAO, n = 28. Gerbils were treated with EA at KI3 or GV20 four times every other day using a set of electrical stimulus pulses (1 mA, 2 Hz) that were applied for 20 min. For investigation of cognitive function, we performed a Y-maze test and Western blotting to identify the expression of neuroinflammatory proteins. EA treatment at KI3 ("Taegye" acupoint) improved cognitive function and reduced the expression of neuroinflammatory proteins including ionized calcium-binding adaptor molecule 1, toll-like receptor 4, tumor necrosis factor alpha, and phospho-extracellular signal-regulated kinase in the hippocampus of gerbils that had undergone BCCAO. Furthermore, using micro-positron emission tomography/computed tomography, we demonstrated that EA treatment increased glucose metabolism in the hippocampus of these animals. The present study highlights the neuroprotective effect of EA treatment against BCCAO-induced memory dysfunction, neuroinflammation, and glucose metabolism. Our findings suggest that EA, which has previously been used in complementary and alternative medicine, might also be considered as a therapy that can improve memory and reduce neuroinflammation associated with dementia.
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Affiliation(s)
- Eun Jin Yang
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 305-811, Republic of Korea
| | - MuDan Cai
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 305-811, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 305-811, Republic of Korea.
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47
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Dietary interventions for maintaining cognitive function in cognitively healthy people in mid life. Hippokratia 2015. [DOI: 10.1002/14651858.cd011911] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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48
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Siervo M, Lara J, Munro A, Tang EYH, Rutjes AWS, Stephan B. Dietary interventions for maintaining cognitive function in cognitively healthy people in late life. Cochrane Database Syst Rev 2015. [DOI: 10.1002/14651858.cd011910] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Mario Siervo
- Newcastle University; Human Nutrition Research Centre, Institute for Ageing and Health; Campus of Ageing and Vitality Newcastle University Newcastle upon Tyne UK NE4 5PL
| | - Jose Lara
- Newcastle University; Human Nutrition Research Centre, Institute for Ageing and Health; Campus of Ageing and Vitality Newcastle University Newcastle upon Tyne UK NE4 5PL
| | - Alex Munro
- Newcastle University; Human Nutrition Research Centre, Institute for Ageing and Health; Campus of Ageing and Vitality Newcastle University Newcastle upon Tyne UK NE4 5PL
| | - Eugene Yee Hing Tang
- Newcastle University; Institute for Ageing and Institute of Health and Society; Baddiley-Clark Building Newcastle upon Tyne UK NE2 4AX
| | - Anne WS Rutjes
- Fondazione "Università G. D'Annunzio"; Centre for Systematic Reviews; Via dei Vestini 31 Chieti Chieti Italy 66100
- University of Bern; Institute of Social and Preventive Medicine (ISPM); Finkenhubelweg 11 Bern Bern Switzerland 3012
| | - Blossom Stephan
- Newcastle University; Institute for Ageing and Institute of Health and Society; Baddiley-Clark Building Newcastle upon Tyne UK NE2 4AX
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49
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Tang EYH, Harrison SL, Albanese E, Gorman TJ, Rutjes AWS, Siervo M, Stephan B. Dietary interventions for prevention of dementia in people with mild cognitive impairment. Cochrane Database Syst Rev 2015. [DOI: 10.1002/14651858.cd011909] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Eugene Yee Hing Tang
- Newcastle University; Institute for Ageing and Institute of Health and Society; Baddiley-Clark Building Newcastle upon Tyne UK NE2 4AX
| | - Stephanie L Harrison
- Newcastle University; Institute of Health and Society; Baddiley-Clark Building Richardson Road Newcastle upon Tyne UK NE2 4AX
| | - Emiliano Albanese
- King's College London; Health Service and Population Research; De Crespigny Park London UK SE22 0HP
| | - Thomas J Gorman
- Newcastle University; Institute of Health and Society; Baddiley-Clark Building Richardson Road Newcastle upon Tyne UK NE2 4AX
| | - Anne WS Rutjes
- Fondazione "Università G. D'Annunzio"; Centre for Systematic Reviews; Via dei Vestini 31 Chieti Chieti Italy 66100
- University of Bern; Institute of Social and Preventive Medicine (ISPM); Finkenhubelweg 11 Bern Bern Switzerland 3012
| | - Mario Siervo
- Newcastle University; Human Nutrition Research Centre, Institute for Ageing and Health; Campus of Ageing and Vitality Newcastle University Newcastle upon Tyne UK NE4 5PL
| | - Blossom Stephan
- Newcastle University; Institute for Ageing and Institute of Health and Society; Baddiley-Clark Building Newcastle upon Tyne UK NE2 4AX
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50
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Al-Assaf AS, Denton DA, Abraham RP, Rutjes AWS, Chong LY, Anderson JL, Malik MA, Tabet N. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in late life. Cochrane Database Syst Rev 2015. [DOI: 10.1002/14651858.cd011906] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Aalya S Al-Assaf
- Brighton and Sussex Medical School, University of Brighton; Division of Medical Education; Mayfield House Falmer UK BN1 9PH
| | - David A Denton
- Sussex Partnership NHS Foundation Trust; Specialist Older People's Services; Uckfield Community Hosptial Framfield Road Uckfield UK TN22 5AW
| | - Rajesh P Abraham
- Cognitive Treatment and Research Unit, Sussex Partnership NHS Foundation Trust; Old Age Psychiatry; Grove House Southfield Road Crowborough UK TN6 1HB
| | - Anne WS Rutjes
- Fondazione "Università G. D'Annunzio"; Centre for Systematic Reviews; Via dei Vestini 31 Chieti Chieti Italy 66100
- University of Bern; Institute of Social and Preventive Medicine (ISPM); Finkenhubelweg 11 Bern Bern Switzerland 3012
| | | | - John L Anderson
- Brighton and Sussex Medical School, University of Brighton; Division of Medical Education; Mayfield House Falmer UK BN1 9PH
| | - Muzaffar A Malik
- Brighton and Sussex Medical School, University of Brighton; Department of Medical Education (Postgraduate); Room 341, Mayfield House Falmer UK BN1 9PH
| | - Naji Tabet
- Brighton and Sussex Medical School; Postgraduate Medicine; Mayfield House, University of Brighton Falmer Brighton UK BN1 9PH
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