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Martyr A, Gamble LD, Hunt A, Quinn C, Morris RG, Henderson C, Allan L, Opdebeeck C, Charlwood C, Jones RW, Pentecost C, Kopelman MD, Thom JM, Matthews FE, Clare L. Differences in trajectories of quality of life according to type of dementia: 6-year longitudinal findings from the IDEAL programme. BMC Med 2024; 22:265. [PMID: 38915081 PMCID: PMC11197262 DOI: 10.1186/s12916-024-03492-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND People with different types of dementia may have distinct symptoms and experiences that affect their quality of life. This study investigated whether quality of life varied across types of dementia and over time. METHODS The participants were 1555 people with mild-to-moderate dementia and 1327 carers from the IDEAL longitudinal cohort study, recruited from clinical services. As many as possible were followed for up to 6 years. Diagnoses included were Alzheimer's disease, vascular dementia, mixed Alzheimer's and vascular dementia, Parkinson's disease dementia, dementia with Lewy bodies, and frontotemporal dementia. Self- and informant-rated versions of the Quality of Life in Alzheimer's Disease scale were used. A joint model, incorporating a mixed effects model with random effects and a survival model to account for dropout, was used to examine whether quality of life varied by dementia type at the time of diagnosis and how trajectories changed over time. RESULTS The strongest associations between dementia type and quality of life were seen around the time of diagnosis. For both self-ratings and informant ratings, people with Parkinson's disease dementia or dementia with Lewy bodies had lower quality of life scores. Over time there was little change in self-rated scores across all dementia types (- 0.15 points per year). Informant-rated scores declined over time (- 1.63 points per year), with the greatest decline seen in ratings by informants for people with dementia with Lewy bodies (- 2.18 points per year). CONCLUSIONS Self-rated quality of life scores were relatively stable over time whilst informant ratings showed a steeper decline. People with Parkinson's disease dementia or dementia with Lewy bodies report particularly low levels of quality of life, indicating the importance of greater attention to the needs of these groups.
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Affiliation(s)
- Anthony Martyr
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, UK.
| | - Anna Hunt
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Robin G Morris
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Catherine Henderson
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Louise Allan
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
| | - Carol Opdebeeck
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Catherine Charlwood
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
| | - Roy W Jones
- Research Institute for the Care of Older People (RICE), Bath, UK
| | - Claire Pentecost
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Michael D Kopelman
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jeanette M Thom
- School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Fiona E Matthews
- Population Health Sciences Institute, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, UK
- Institute for Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
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Yeung MK. Metamemory and executive function mediate the age-related decline in memory. J Int Neuropsychol Soc 2024; 30:479-488. [PMID: 38221867 DOI: 10.1017/s1355617723011451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVE Although the effect of aging on episodic memory is relatively well studied, little is known about how aging influences metamemory. In addition, while executive function (EF) is known to mediate the age-related decline in episodic memory, the role of metamemory in aging-related memory differences beyond EF remains unknown. This study aimed to elucidate the effect of aging on metamemory and to clarify the role of metamemory in the age-related decline in memory. METHOD One hundred and four adults aged 18-79 years (50 M, 54 F) performed several EF tasks, as well as a face-scene paired-associate learning task that required them to make judgments of learning, feeling-of-knowing judgments, and retrospective confidence judgments. RESULTS Aging was significantly associated with poor metamemory accuracy and increased confidence across metamemory judgment types, even after controlling for EF and memory performance. A parallel mediation analysis indicated that both confidence of learning and EF performance had significant partial mediation effects on the relationship between aging and memory, albeit in different ways. Specifically, poor EF explained the age-related decline in memory, whereas increased confidence of learning served to compensate for this memory decline. CONCLUSIONS Aging is associated with general changes (i.e., poor inferences from cues) rather than specific changes (i.e., declined activation or utilization of certain cues) in metamemory monitoring. Also, changes in confidence of learning and in EF ability contribute to the preservation and decline of memory during aging, respectively. Therefore, boosting confidence during encoding and enhancing EF skills might be complementary memory intervention strategies for older adults.
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Affiliation(s)
- Michael K Yeung
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
- University Research Facility in Behavioral and Systems Neuroscience, The Hong Kong Polytechnic University, Hong Kong, China
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Yeung MK. Effects of age on the interactions of attentional and emotional processes: a prefrontal fNIRS study. Cogn Emot 2024; 38:549-564. [PMID: 38303643 DOI: 10.1080/02699931.2024.2311799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
The aging of attentional and emotional functions has been extensively studied but relatively independently. Therefore, the relationships between aging and the interactions of attentional and emotional processes remain elusive. This study aimed to determine how age affected the interactions between attentional and emotional processes during adulthood. One-hundred forty adults aged 18-79 performed the emotional variant of the Attention Network Test, which probed alerting, orienting, and executive control in the presence and absence of threatening faces. During this task, contexts with varying levels of task preparatory processes were created to modulate the effect of threatening faces on attention, and functional near-infrared spectroscopy (fNIRS) was used to examine the neural underpinnings of the behavioural effects. The behavioural results showed that aging was associated with a significant decline in alerting efficiency, and there was a statistical trend for age-related deficits in executive control. Despite these age differences, age did not significantly moderate the interactions among attentional networks or between attention and emotion. Additionally, the fNIRS results showed that decreased frontal cortex functioning might underlie the age-related decline in executive control. Therefore, while aging has varying effects on different attentional networks, the interactions of attentional and emotional processes remain relatively unaffected by age.
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Affiliation(s)
- Michael K Yeung
- Department of Psychology, The Education University of Hong Kong, Hong Kong, People's Republic of China
- University Research Facility in Behavioral and Systems Neuroscience, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
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Warner LM, Jiang D, Yeung DYL, Choi NG, Ho RTH, Kwok JYY, Song Y, Chou KL. Study protocol of the 'HEAL-HOA' dual randomized controlled trial: Testing the effects of volunteering on loneliness, social, and mental health in older adults. Contemp Clin Trials Commun 2024; 38:101275. [PMID: 38435428 PMCID: PMC10904923 DOI: 10.1016/j.conctc.2024.101275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/10/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
Background Interventions to reduce loneliness in older adults usually do not show sustained effects. One potential way to combat loneliness is to offer meaningful social activities. Volunteering has been suggested as one such activity - however, its effects on loneliness remain to be tested in randomized controlled trials (RCT). Methods This planned Dual-RCT aims to recruit older adults experiencing loneliness, with subsequent randomization to either a volunteering condition (6 weeks of training before delivering one of three tele-based loneliness interventions to older intervention recipients twice a week for 6 months) or to an active control condition (psycho-education with social gatherings for six months). Power analyses require the recruitment of N = 256 older adults to detect differences between the volunteering and the active control condition (128 in each) on the primary outcome of loneliness (UCLA Loneliness Scale). Secondary outcomes comprise social network engagement, perceived social support, anxiety and depressive symptoms, self-rated health, cognitive health, perceived stress, sleep quality, and diurnal cortisol (1/3 of the sample). The main analyses will comprise condition (volunteering vs. no-volunteering) × time (baseline, 6-, 12-, 18-, 24-months follow-ups) interactions to test the effects of volunteering on loneliness and secondary outcomes. Effects are expected to be mediated via frequency, time and involvement in volunteering. Discussion If our trial can show that volunteers delivering one of the three telephone-based interventions to lonely intervention recipients benefit from volunteer work themselves, this might encourage more older adults to volunteer, helping to solve some of the societal issues involved with rapid demographic changes.
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Affiliation(s)
- Lisa M. Warner
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Da Jiang
- The Education University of Hong Kong, 10 Lo Ping Rd, Tai Po, Hong Kong
| | - Dannii Yuen-lan Yeung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Ave, Kowloon Tong, Hong Kong
| | - Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, USA
| | - Rainbow Tin Hung Ho
- Department of Social Work & Social Administration, Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Youqiang Song
- Department of Biochemistry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kee-Lee Chou
- The Education University of Hong Kong, 10 Lo Ping Rd, Tai Po, Hong Kong
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Yeung WF, Chen SC, Cheung DST, Wong CKH, Chong TC, Ho YS, Suen LKP, Ho LM, Lao L. Self-Administered Acupressure for Probable Knee Osteoarthritis in Middle-Aged and Older Adults: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e245830. [PMID: 38639940 PMCID: PMC11031685 DOI: 10.1001/jamanetworkopen.2024.5830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/12/2024] [Indexed: 04/20/2024] Open
Abstract
Importance The effects of self-administered acupressure (SAA) on knee osteoarthritis (OA) pain remain unclear. Objective To evaluate the effectiveness of SAA taught via a short training course on reducing knee OA pain in middle-aged and older adults. Design, Setting, and Participants This randomized clinical trial was conducted among community-dwelling individuals in Hong Kong who were aged 50 years or older with probable knee OA from September 2019 to May 2022. Interventions The intervention included 2 training sessions for SAA with a brief knee health education (KHE) session, in which participants practiced acupressure twice daily for 12 weeks. The control group (KHE only) received only education about maintaining knee health on the same schedule and duration. Main Outcomes and Measures The primary outcome was the numerical rating scale (NRS) pain score at 12 weeks. Other outcomes included Western Ontario and McMaster University Osteoarthritis Index, Short Form 6 Dimensions (SF-6D), Timed Up and Go, and Fast Gait Speed tests. Results A total of 314 participants (mean [SD] age, 62.7 [4.5] years; 246 [78.3%] female; mean [SD] knee pain duration, 7.3 [7.6] years) were randomized into intervention and KHE-only groups (each 157). At week 12, compared with the KHE-only group, the intervention group had a significantly greater reduction in NRS pain score (mean difference [MD], -0.54 points; 95% CI, -0.97 to -0.10 points; P = .02) and higher enhancement in SF-6D utility score (MD, 0.03 points; 95% CI, 0.003 to 0.01 points; P = .03) but did not have significant differences in other outcome measures. The cost-effectiveness acceptability curve demonstrated a greater than 90% probability that the intervention is cost-effective at a willingness to pay threshold of 1 GDP per capita. Conclusions and Relevance In this randomized clinical trial, SAA with a brief KHE program was efficacious and cost-effective in relieving knee pain and improving mobility in middle-aged and older adults with probable knee OA. Trial Registration ClinicalTrials.gov Identifier: NCT04191837.
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Affiliation(s)
- Wing-Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Center for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Shu-Cheng Chen
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Carlos King-Ho Wong
- Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Department of Infectious Disease Epidemiology & Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Yuen Shan Ho
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Lai Ming Ho
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Lixing Lao
- Virginia University of Integrative Medicine, Vienna, Virginia
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Kor PPK, Parial LL, Yu CTK, Liu JYW, Liu DPM, Hon JMK. Effects of a Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention for Older People With Dementia During Coronavirus 2019: A Randomized Controlled Trial. THE GERONTOLOGIST 2024; 64:gnad054. [PMID: 37179458 DOI: 10.1093/geront/gnad054] [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: 01/20/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Many community dementia services such as home-visiting services and center-based activities were suspended during the coronavirus 2019 pandemic. This study investigated the efficacy of a caregiver-delivered cognitive stimulation therapy (CDCST) on people with dementia during the pandemic. RESEARCH DESIGN AND METHODS This was a 2-arm randomized controlled trial involving 241 patient-caregiver dyads assigned to a 15-week CDCST or control group (usual care). We hypothesized that CDCST would facilitate significant improvements among people with dementia (cognition, behavioral/psychiatric symptoms, and quality of life) and their caregivers (caregiving appraisal, attitudes, and psychological well-being) at postintervention (T1) and at the 12-week follow-up (T2). Generalized estimating equations evaluated the study outcomes. RESULTS A total of 230 dyads completed the study, with good program adherence (93%). Participants in the CDCST showed significant improvements in cognition (p < .001), behavioral and psychiatric symptoms (p =. 027), and quality of life (p =.001) at the 3-month follow-up period. Family caregivers had improved positive aspects of caregiving (p = .008; p = .049) and decreased negative attitudes toward people with dementia (p =. 013; p < .001) at both T1 and T2. There were nonsignificant changes in the caregivers' perceived burden, distress, and psychological well-being. DISCUSSION AND IMPLICATIONS Family caregivers could be trained to provide cognitive stimulation at home for people with dementia, which could benefit both parties. CDCST could manage to improve the cognition, neuropsychiatric symptoms, and quality of life of people with dementia, while also improving caregiving appraisal and negative attitudes among family caregivers. CLINICAL TRIAL REGISTRATION NUMBER NCT03803592.
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Affiliation(s)
- Patrick Pui Kin Kor
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | | | - Clare Tsz Kiu Yu
- Division of Psychiatry, University of College London, London, UK
| | - Justina Yat Wah Liu
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Denise Pik Mei Liu
- Ming Yue District Elderly Community Centre, Hong Kong Young Women's Christian Association, Hong Kong SAR, China
| | - Joan Mo King Hon
- Hong Kong Young Women's Christian Association, Hong Kong SAR, China
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Han Y, Zeng X, Hua L, Quan X, Chen Y, Zhou M, Chuang Y, Li Y, Wang S, Shen X, Wei L, Yuan Z, Zhao Y. The fusion of multi-omics profile and multimodal EEG data contributes to the personalized diagnostic strategy for neurocognitive disorders. MICROBIOME 2024; 12:12. [PMID: 38243335 PMCID: PMC10797890 DOI: 10.1186/s40168-023-01717-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/07/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND The increasing prevalence of neurocognitive disorders (NCDs) in the aging population worldwide has become a significant concern due to subjectivity of evaluations and the lack of precise diagnostic methods and specific indicators. Developing personalized diagnostic strategies for NCDs has therefore become a priority. RESULTS Multimodal electroencephalography (EEG) data of a matched cohort of normal aging (NA) and NCDs seniors were recorded, and their faecal samples and urine exosomes were collected to identify multi-omics signatures and metabolic pathways in NCDs by integrating metagenomics, proteomics, and metabolomics analysis. Additionally, experimental verification of multi-omics signatures was carried out in aged mice using faecal microbiota transplantation (FMT). We found that NCDs seniors had low EEG power spectral density and identified specific microbiota, including Ruminococcus gnavus, Enterocloster bolteae, Lachnoclostridium sp. YL 32, and metabolites, including L-tryptophan, L-glutamic acid, gamma-aminobutyric acid (GABA), and fatty acid esters of hydroxy fatty acids (FAHFAs), as well as disturbed biosynthesis of aromatic amino acids and TCA cycle dysfunction, validated in aged mice. Finally, we employed a support vector machine (SVM) algorithm to construct a machine learning model to classify NA and NCDs groups based on the fusion of EEG data and multi-omics profiles and the model demonstrated 92.69% accuracy in classifying NA and NCDs groups. CONCLUSIONS Our study highlights the potential of multi-omics profiling and EEG data fusion in personalized diagnosis of NCDs, with the potential to improve diagnostic precision and provide insights into the underlying mechanisms of NCDs. Video Abstract.
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Affiliation(s)
- Yan Han
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China
| | - Xinglin Zeng
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China
| | - Lin Hua
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China
| | - Xingping Quan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China
| | - Ying Chen
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, 210023, Jiangsu, China
| | - Manfei Zhou
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China
| | | | - Yang Li
- Department of Gastrointestinal Surgery, Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, 518020, China
| | - Shengpeng Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China
| | - Xu Shen
- Jiangsu Key Laboratory of Drug Target and Drug for Degenerative Diseases, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Lai Wei
- School of Pharmaceutical Science, Southern Medical University, Guangzhou, 510515, China
| | - Zhen Yuan
- Centre for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China.
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, 999078, Macau SAR, China.
- Department of Pharmaceutical Sciences, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR 999078, China.
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Basagni B, Malloggi S, Polito C, Pellicciari L, Campagnini S, Pancani S, Mannini A, Gemignani P, Salvadori E, Marignani S, Giovannelli F, Viggiano MP, Hakiki B, Grippo A, Macchi C, Cecchi F. MoCA Domain-Specific Pattern of Cognitive Impairment in Stroke Patients Attending Intensive Inpatient Rehabilitation: A Prospective Study. Behav Sci (Basel) 2024; 14:42. [PMID: 38247694 PMCID: PMC10813017 DOI: 10.3390/bs14010042] [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: 10/31/2023] [Revised: 12/18/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
A domain-specific perspective to cognitive functioning in stroke patients may predict their cognitive recovery over time and target stroke rehabilitation intervention. However, data about domain-specific cognitive impairment after stroke are still scarce. This study prospectively investigated the domain-specific pattern of cognitive impairments, using the classification proposed by the Montreal Cognitive Assessment (MoCA), in a cohort of 49 stroke patients at admission (T0), discharge (T1), and six-month follow-up (T2) from subacute intensive rehabilitation. The predictive value of T0 cognitive domains cognitive impairment at T1 and T2 was also investigated. Patients' cognitive functioning at T0, T1, and T2 was assessed through the MoCA domains for executive functioning, attention, language, visuospatial, orientation, and memory. Different evolutionary trends of cognitive domain impairments emerged across time-points. Patients' impairments in all domains decreased from T0 to T1. Attention and executive impairments decreased from T0 to T2 (42.9% and 26.5% to 10.2% and 18.4%, respectively). Conversely, altered visuospatial, language, and orientation increased between T1 and T2 (16.3%, 36.7%, and 40.8%, respectively). Additionally, patients' global cognitive functioning at T1 was predicted by the language and executive domains in a subacute phase (p = 0.031 and p = 0.001, respectively), while in the long term, only attention (p = 0.043) and executive (p = 0.019) domains intervened. Overall, these results confirm the importance of a domain-specific approach to target cognitive recovery across time in stroke patients.
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Affiliation(s)
- Benedetta Basagni
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Serena Malloggi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Cristina Polito
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Leonardo Pellicciari
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Paola Gemignani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Emilia Salvadori
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Sara Marignani
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Fabio Giovannelli
- Department of NEUROFARBA, University of Florence, 50143 Firenze, Italy; (F.G.); (M.P.V.)
| | - Maria Pia Viggiano
- Department of NEUROFARBA, University of Florence, 50143 Firenze, Italy; (F.G.); (M.P.V.)
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Antonello Grippo
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
- Department of Experimental and Clinical Medicine, University of Florence, 50143 Firenze, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Firenze, Italy; (B.B.); (S.M.); (C.P.); (L.P.); (S.P.); (A.M.); (P.G.); (E.S.); (S.M.); (B.H.); (A.G.); (C.M.); (F.C.)
- Department of Experimental and Clinical Medicine, University of Florence, 50143 Firenze, Italy
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Hoshide S, Nishizawa M, Kanegae H, Kario K. Home blood pressure measurement consistency and cognitive impairment. Hypertens Res 2024; 47:177-183. [PMID: 37726350 DOI: 10.1038/s41440-023-01436-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
Cognitive function tends to decline with age, and individuals with mild cognitive impairment (MCI) often have difficulty completing established self-management tasks. The aim of this study was to investigate the association between the number of days within a 5-and-a-half-day period that patients took their home blood pressure (BP) as instructed and MCI assessed by the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in an elderly clinical population. We analyzed 303 ambulatory patients (mean age 77.3 ± 8.2 years) in whom MoCA-J had been assessed, who were instructed to take home BP for 1 evening and twice a day for the next five days, and who had at least one morning home BP measurement. After accounting for patient characteristics including age, sex, body mass index, drinking, smoking, prevalent cardiovascular disease, morning systolic BP and diastolic BP, and the use of antihypertensive drugs, the number of days home BP was measured was independently associated with both total MoCA-J score (estimate, 0.82; 95% confidence interval [CI], 0.43-1.21; P < 0.001) and the lowest quartile of MoCA-J score (13 or below) (odds ratio [OR], 0.72; 95%CI, 0.59-0.87; P = 0.001). Home BP measurement noncompliance (<5 days' measurement) was also independently associated with the total MoCA-J score (estimate, -2.56; 95%CI, -4.09 to -1.03; P = 0.001) and the lowest quartile of MoCA-J score (OR, 3.32; 95%CI, 1.59-6.96; P = 0.001). In conclusion, poor compliance with home BP monitoring was associated with cognitive impairment in elderly cases who had been specifically instructed to perform home BP monitoring during a designated period.
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Affiliation(s)
- Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | | | | | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
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10
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Lai CYY, Chen LH, Lai FHY, Fung AWT, Ng SSM. The association between satisfaction with life and anxiety symptoms among Chinese elderly: a moderated mediation analysis. BMC Geriatr 2023; 23:855. [PMID: 38097936 PMCID: PMC10722706 DOI: 10.1186/s12877-023-04490-0] [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: 05/25/2023] [Accepted: 11/19/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Previous studies have suggested that certain personal psychological variables (e.g., life satisfaction and cognitive function) and physical variables (e.g., body mass index [BMI]) are significantly associated with individuals' anxiety symptoms. However, relevant research on elderly is lagging and no studies have yet investigated the combined impact of these variables on anxiety. Thus, we conducted the present study to investigate the potential moderator role of BMI and the potential mediator role of cognitive function underlying the relationship between life satisfaction and anxiety symptoms in Chinese elderly based in Hong Kong. METHODS Sixty-seven elderly aged 65 years old and above were recruited from the local elderly community centres in this pilot study. Each participant underwent a systematic evaluation using the Satisfaction with Life Scale (SWLS), Hong Kong Version of the Montreal Cognitive Assessment (HK-MoCA), and the Hamilton Anxiety Rating Scale (HAM-A) and were measured for their body weight and height. Regression analysis using the bootstrapping method was employed to test the hypothesized moderated mediation model. RESULTS Our findings demonstrated the overall model accounted for 23.05% of the variance in scores of HAM-A (F (8, 57) = 2.134, p = 0.047) in Chinese elderly. There was a significant association between life satisfaction and anxiety symptoms (p = 0.031), indicating that individuals with higher life satisfaction were associated with less anxiety symptoms. Moreover, this relationship was positively moderated by BMI (b = 0.066, 95% CI [0.004, 0.128]), especially in Chinese elderly with BMI at a lower level (b = -0.571, 95% CI [-0.919, -0.224]) and an average level (b = -0.242, 95% CI [-0.460, -0.023]). No significant mediator role was detected for cognitive function (b = -0.006, 95% CI [-0.047, 0.044]) in our model. CONCLUSIONS Our findings suggest that increased life satisfaction can reduce anxiety symptoms among Chinese elderly as their BMI decreases (when BMI ranged between "mean - 1SD" and "mean" of the population). The significant interaction between psychological and physical factors underlying anxiety symptoms found in this study, presents a promising opportunity for translation into multi-level psychological and physical interventions for the management of anxiety in ageing patients during clinical practice.
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Affiliation(s)
- Cynthia Y Y Lai
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Lu Hua Chen
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong SAR, China.
- Mental Health Research Center (MHRC), The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Frank H Y Lai
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, The Northumbria University, Newcastle upon Tyne, UK
| | - Ada W T Fung
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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11
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Kang K, Xiao Y, Yu H, Diaz MT, Zhang H. Multilingual Language Diversity Protects Native Language Production under Different Control Demands. Brain Sci 2023; 13:1587. [PMID: 38002547 PMCID: PMC10670415 DOI: 10.3390/brainsci13111587] [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: 10/05/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
The use of multiple languages has been found to influence individuals' cognitive abilities. Although some studies have also investigated the effect of multilingualism on non-native language proficiency, fewer studies have focused on how multilingual experience affects native language production. This study investigated the effect of multilingualism on native language production, specifically examining control demands through a semantic Go/No-Go picture naming task. The multilingual experience was quantified using language entropy, which measures the uncertainty and diversity of language use. Control demands were achieved by manipulating the proportion of Go (i.e., naming) trials in different conditions. Results showed that as control demands increased, multilingual individuals exhibited poorer behavioral performance and greater brain activation throughout the brain. Moreover, more diverse language use was associated with higher accuracy in naming and more interconnected brain networks with greater involvement of domain-general neural resources and less domain-specific neural resources. Notably, the varied and balanced use of multiple languages enabled multilingual individuals to respond more efficiently to increased task demands during native language production.
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Affiliation(s)
- Keyi Kang
- Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macau SAR, China
- Department of Psychology, University of Macau, Taipa, Macau SAR, China
| | - Yumeng Xiao
- Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macau SAR, China
| | - Hanxiang Yu
- Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macau SAR, China
| | - Michele T. Diaz
- Department of Psychology, The Pennsylvania State University, State College, PA 16801, USA
| | - Haoyun Zhang
- Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macau SAR, China
- Department of Psychology, University of Macau, Taipa, Macau SAR, China
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12
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Clare L. Evaluating 'living well' with mild-to-moderate dementia: Co-production and validation of the IDEAL My Life Questionnaire. DEMENTIA 2023; 22:1548-1566. [PMID: 37436256 PMCID: PMC10966933 DOI: 10.1177/14713012231188502] [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] [Indexed: 07/13/2023]
Abstract
OBJECTIVES We aimed to co-produce and validate an accessible, evidence-based questionnaire measuring 'living well' with dementia that reflects the experience of people with mild-to-moderate dementia. METHODS Nine people with dementia formed a co-production group. An initial series of workshops generated the format of the questionnaire and a longlist of items. Preliminary testing with 53 IDEAL cohort participants yielded a shortlist of items. These were tested with 136 IDEAL cohort participants during a further round of data collection and assessed for reliability and validity. The co-production group contributed to decisions throughout and agreed the final version. RESULTS An initial list of 230 items was reduced to 41 for initial testing, 12 for full testing, and 10 for the final version. The 10-item version had good internal consistency and test-retest reliability, and a single factor structure. Analyses showed significant large positive correlations with scores on measures of quality of life, well-being, and satisfaction with life, and expected patterns of association including a significant large negative association with depression scores and no association with cognitive test scores. CONCLUSIONS The co-produced My Life Questionnaire is an accessible and valid measure of 'living well' with dementia suitable for use in a range of contexts.
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Affiliation(s)
- Linda Clare
- Linda Clare, University of Exeter Medical School, St Luke's Campus, Exeter EX1 2LU, UK.
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13
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Zhao Y, Yu L, Fan X, Pang MYC, Tsui KL, Wang H. Design of a Sensor-Technology-Augmented Gait and Balance Monitoring System for Community-Dwelling Older Adults in Hong Kong: A Pilot Feasibility Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:8008. [PMID: 37766060 PMCID: PMC10535689 DOI: 10.3390/s23188008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
Routine assessments of gait and balance have been recognized as an effective approach for preventing falls by issuing early warnings and implementing appropriate interventions. However, current limited public healthcare resources cannot meet the demand for continuous monitoring of deteriorations in gait and balance. The objective of this study was to develop and evaluate the feasibility of a prototype surrogate system driven by sensor technology and multi-sourced heterogeneous data analytics, for gait and balance assessment and monitoring. The system was designed to analyze users' multi-mode data streams collected via inertial sensors and a depth camera while performing a 3-m timed up and go test, a five-times-sit-to-stand test, and a Romberg test, for predicting scores on clinical measurements by physiotherapists. Generalized regression of sensor data was conducted to build prediction models for gait and balance estimations. Demographic correlations with user acceptance behaviors were analyzed using ordinal logistic regression. Forty-four older adults (38 females) were recruited in this pilot study (mean age = 78.5 years, standard deviation [SD] = 6.2 years). The participants perceived that using the system for their gait and balance monitoring was a good idea (mean = 5.45, SD = 0.76) and easy (mean = 4.95, SD = 1.09), and that the system is useful in improving their health (mean = 5.32, SD = 0.83), is trustworthy (mean = 5.04, SD = 0.88), and has a good fit between task and technology (mean = 4.97, SD = 0.84). In general, the participants showed a positive intention to use the proposed system in their gait and balance management (mean = 5.22, SD = 1.10). Demographic correlations with user acceptance are discussed. This study provides preliminary evidence supporting the feasibility of using a sensor-technology-augmented system to manage the gait and balance of community-dwelling older adults. The intervention is validated as being acceptable, viable, and valuable.
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Affiliation(s)
- Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518000, China;
| | - Lisha Yu
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Xiaomao Fan
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen 518000, China;
| | - Marco Y. C. Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Kwok-Leung Tsui
- Grado Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China;
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14
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Sun R, Ge B, Wu S, Li H, Lin L. Optimal cut-off MoCA score for screening for mild cognitive impairment in elderly individuals in China: A systematic review and meta-analysis. Asian J Psychiatr 2023; 87:103691. [PMID: 37499366 DOI: 10.1016/j.ajp.2023.103691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/16/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
AIM To evaluate the optimal cut-off MoCA score for elderly individuals with MCI. DESIGN A systematic review and meta-analysis. METHOD Articles were retrieved from PubMed, Ovid, Embase, The Cochrane Library, PsycINFO, CBM, CNKI, WanFang and CQVIP and were assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Figures of the assessment were made by using Review Manager 5.3, and a meta-analysis of the data was conducted by using Bivariate Random-effects Meta-Analysis (BRMA) via Stata 14.0. RESULTS Seventeen articles were retrieved from the database, and when the cut-offs were 24/25 and 25/26, they represented the same diagnostic value; in addition, the AUC was 0.96, which demonstrated high predictive validity for mild cognitive impairment screening. However, the sensitivity was higher with 25/26 (se=0.95, sp=0.80), whereas the specificity was higher with 24/25 (se=0.92, sp=0.89).
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Affiliation(s)
- Rui Sun
- International Medical Services, Peking Union Medical College Hospital, Beijing, China
| | - Binqian Ge
- School of Nursing, Suzhou Vocational Health College, Suzhou, China
| | - Shiyu Wu
- International Medical Services, Peking Union Medical College Hospital, Beijing, China
| | - Huiling Li
- School of Nursing, Soochow University and The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Lu Lin
- The First Affiliated Hospital of Soochow University, Suzhou, China.
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15
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Wang SM, Lam BYH, Kuo LC, Hsu HM, Ouyang WC. Facial and upper-limb movement abnormalities in individuals with psychotic-like experiences: a motion analysis study. Eur Arch Psychiatry Clin Neurosci 2023; 273:1369-1377. [PMID: 36350375 DOI: 10.1007/s00406-022-01517-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
Slow movements and irregular muscle contraction have been reported separately in different studies targeting individuals with psychotic-like experiences (PLEs). To date, it remains unknown whether these two movement abnormalities, possibly associated with hypo- and hyper-dopaminergia, respectively, co-existed in one sample with PLEs and interrelated in the early stage of psychotic progression. Therefore, this study was to examine if facial and upper-limb slow movements and irregular muscle contraction co-existed in individuals with PLEs, interrelated, and were associated with PLEs. A total of 26 individuals with PLEs, who were identified using the 16-item Prodromal Questionnaire, and 26 age- and gender-matched healthy controls received the facial and upper-limb movement measurement. A motion capture system was used to record the movement procedure and thus calculate kinematic variables that represented severity of slow movements and irregular muscle contraction. Results showed that facial and upper-limb slow movements and facial irregular muscle contraction existed in individuals with PLEs. For the total sample, slower facial movements were associated with less regular facial muscle contraction; slower upper-limb movements were associated with less regular upper-limb muscle contraction. Slower and less regular facial and upper-limb movements were associated with more severe PLEs. Compensatory changes in dopaminergic neural pathways in response to elevated dopamine might explain connection between slow movements and irregular muscle contraction. Because of the ability to detect facial and upper-limb movement abnormalities objectively and sensitively, motion analysis has great applicability to sensorimotor studies for people in the psychosis continuum.
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Affiliation(s)
- Shu-Mei Wang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong.
| | - Bess Yin-Hung Lam
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong
| | - Li-Chieh Kuo
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Man Hsu
- Clinical Medicine and Advanced Applied Research Department, Point Robotics Medtech Incorporation, Taipei, Taiwan
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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16
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Jin RR, Cheung CNM, Wong CH, Lo CC, Lee CP, Tsang HW, Virwani PD, Ip P, Lau KK, Lee TM. Sleep quality mediates the relationship between systemic inflammation and neurocognitive performance. Brain Behav Immun Health 2023; 30:100634. [PMID: 37251546 PMCID: PMC10209676 DOI: 10.1016/j.bbih.2023.100634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 05/31/2023] Open
Abstract
Background Systemic inflammation is a significant mechanism underpinning adverse cognitive changes. Sleep quality is a crucial factor associated with systemic inflammation and neurocognitive health. Elevated levels of pro-inflammatory cytokines in the periphery help mark inflammation. With this background, we examined the relationship between systemic inflammation, subjective sleep quality, and neurocognitive performance in adults. Method & Results In 252 healthy adults, we measured the systemic inflammation reflected by serum levels of IL-6, IL-12, IL-18, TNF-α and IFN-γ, subjective sleep quality reflected by the global scores of the Pittsburgh Sleep Quality Index, and their neurocognitive performance measured by the Hong Kong Montreal Cognitive Assessment. We observed that neurocognitive performance was negatively related to IL-18 (p = 0.046) and positively related to sleep quality (p = 0.006). We did not observe significant associations between other cytokines and neurocognitive performance. Furthermore, we found that sleep quality as a mediator explained the relationship between IL-18 and neurocognitive performance depending on the levels of IL-12 (index of moderated mediation: 95% CI = [0.0047, 0.0664]). Better subjective sleep quality buffered the negative effect of IL-18 on neurocognitive performance when IL-12 was low (bootstrapping 95% CI: [- 0.0824, - 0.0018]). On the contrary, poor subjective sleep quality mediated the association between higher IL-18 and poorer neurocognitive performance when IL-12 was elevated (bootstrapping 95% CI: [0.0004, 0.0608]). Conclusion & Implications Our findings indicate that systemic inflammation was negatively associated with neurocognitive performance. Sleep quality regulated by IL-18/IL-12 axis activation could be a potential mechanism underpinning neurocognitive changes. Our results illustrate the intricate relationships between immune functioning, sleep quality and neurocognitive performance. These insights are essential to understand the potential mechanisms underpinning neurocognitive changes, paving the way for the development of preventive interventions for the risk of cognitive impairment.
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Affiliation(s)
- Rachel R. Jin
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Carman Nga-Man Cheung
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Clive H.Y. Wong
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - Chelsea C.W. Lo
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Crystal P.I. Lee
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Hing Wai Tsang
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Preeti Dinesh Virwani
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kui Kai Lau
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Division of Neurology, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tatia M.C. Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
- Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
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17
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Xu Z, Zhang D, Zheng X, Lee RCM, Wong SYS, Wong CKM. Use, satisfaction, and preference of online health services among older adults with multimorbidity in Hong Kong primary care during COVID-19. BMC Geriatr 2023; 23:368. [PMID: 37322428 PMCID: PMC10268343 DOI: 10.1186/s12877-023-04061-3] [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: 09/28/2022] [Accepted: 05/23/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The use of online and mobile internet and social media has been increasing in healthcare service delivery. However, there is limited literature on the acceptance and use of online health services for older adults with multimorbidity who require more medical care and assistance. This study aims to explore the use of social media in older adults with multimorbidity in Hong Kong primary care and to assess the feasibility and usage of online health services in this population, including satisfaction, preference, and problems encountered. METHODS This is a cross-sectional study among older adults with multimorbidity conducted between November 2020 and March 2021 in a Hong Kong primary care programme. Online and face-to-face services were offered based on the needs of the participants. Demographic characteristics and health conditions were assessed at baseline. Participants using online services were invited to complete a feedback questionnaire. RESULTS The study included 752 participants, of which 66.1% use social media every day. Participants who declined to use online services were found to be significantly older, live alone, have lower income, have social security assistance, have greater cognitive decline, and be less depressed (p < 0.05). Non-responders to the online questionnaire had fewer years of education and greater cognitive decline (p < 0.05). The median satisfaction with the online services was 8 (interquartile range: 7, 9), and 14.6% of the participants preferred online more than face-to-face services. Lower education levels, fewer internet connection issues, and more self-efficacy on mobile apps were associated with a higher level of online satisfaction after adjustment (p < 0.05). Fewer internet connection issues and more self-efficacy on mobile apps were associated with participants' preference for online services (p < 0.05). CONCLUSIONS More than half of Hong Kong older adults with multimorbidity in primary care use social media daily. Internet connection issues can be a significant barrier to the usage of online services in this population. Prior use and training can be beneficial to enhance use and satisfaction in older adults.
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Affiliation(s)
- Zijun Xu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaoxiang Zheng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Rym C M Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Y S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Carmen K M Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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18
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Kim H, Yang S, Park J, Kim BC, Yu KH, Kang Y. Effect of Education on Discriminability of Montreal Cognitive Assessment Compared to Mini-Mental State Examination. Dement Neurocogn Disord 2023; 22:69-77. [PMID: 37179689 PMCID: PMC10166679 DOI: 10.12779/dnd.2023.22.2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Background and Purpose The Montreal Cognitive Assessment (MoCA) has been known as a screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State Examination (MMSE). However, in previous domestic studies, no significant difference was found in the discriminability between MoCA and MMSE. Researchers have suggested that this might be because older Koreans are less educated than older Westerners. This study was conducted to examine the effect of education on the discriminability of MoCA compared to the MMSE. Methods Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer's type. The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple regression analyses and receiver operating characteristic (ROC) curve analyses were performed. Results In all participants, education significantly affected both K-MoCA and K-MMSE scores along with age. The effect of education was re-examined by subgroup analysis after dividing subjects according to the level of education. Effect of education on K-MoCA and K-MMSE was only shown in the group with <9 years of education. ROC curve analyses revealed that the discriminability of K-MoCA to differentiate between vascular MCI and normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups divided by education level, however, this higher discriminability of K-MoCA disappeared in the group with <9 years of education. Conclusions These results indicate no difference in discriminating cognitive deficits between K-MoCA and K-MMSE in Korean elderly with <9 years of education.
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Affiliation(s)
- Haeyoon Kim
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
- Department of Neurology, Choennam National University Hospital, Gwangju, Korea
| | - Seonyeong Yang
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
| | - Jaesel Park
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Byeong Chae Kim
- Department of Neurology, Choennam National University Hospital, Gwangju, Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yeonwook Kang
- Department of Psychology, College of Social Sciences, Hallym University, Chuncheon, Korea
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19
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Zhou L, Huang B, Wang J, Chau SW, Chan JW, Zhang J, Yu MW, Tsang JC, Li SX, Mok VC, Wing YK, Liu Y. Early- and late-onset of isolated rapid eye movement sleep behavior disorder: A retrospective cohort study. Sleep Med 2023; 105:1-8. [PMID: 36934616 DOI: 10.1016/j.sleep.2023.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/12/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE Age at onset of neurodegenerative disease has significant implications in differentiating disease profiles. We aimed to determine whether age at onset could identify clinical and neurodegenerative profiles in patients with isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) - a prodromal stage of α-synucleinopathies. METHODS In this retrospective cohort study, the time of the first episode of dream-enactment behaviors that the patient/bed-partners recalled at the time of the patient's first visit to sleep clinic was collected. The distribution of age at onset was examined and patients were dichotomized into early- and late-onset groups based on the intersection point of underlying two Gaussian distributions of onset age. RESULTS A total of 241 patients were included. The intersection of underlying two Gaussian models of onset age was 64.6 years, yielding 168 early- (median onset age: 58.0 years, range: 38.0-64.0) and 73 late-onset patients (median onset age: 70.0 years, range: 65.0-82.0). Among them, 154 of early- and 68 late-onset patients were followed-up. Late-onset patients had milder RBD symptoms, but worse sleep, cognition, olfactory and motor functions, and a higher risk of phenoconversion (adjusted hazard ratio (aHR) = 2.2, 95% confidence interval (CI) = 1.2-3.9), especially to probable dementia with Lewy bodies (DLB) (aHR = 8.9, 95% CI = 3.0-26.2), than early-onset patients. CONCLUSIONS Late-onset iRBD was associated with a higher level of neurodegenerative markers and a quicker phenoconversion, especially to probable DLB. Age at onset of iRBD could help identify clinical features and predict prognosis of iRBD.
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Affiliation(s)
- Li Zhou
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bei Huang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jing Wang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Steven Wh Chau
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joey Wy Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Mandy Wm Yu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessie Cc Tsang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Vincent Ct Mok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yun Kwok Wing
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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20
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Zhang X, Zhang N, Yang Y, Wang S, Yu P, Guan BY, Wang CX. Living alone and health-related quality of life among adults with obstructive sleep apnea in a single-center cohort study. Sleep Breath 2023; 27:221-227. [PMID: 35352266 PMCID: PMC8964248 DOI: 10.1007/s11325-022-02604-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/04/2022] [Accepted: 03/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the impact of a solitary lifestyle on health-related quality of life (HRQoL) in adults with obstructive sleep apnea (OSA). METHODS This was a prospective cohort study; patients diagnosed with OSA but not receiving continuous positive airway pressure (CPAP) therapy were enrolled in our study. These participants completed basic information and the Short Form-36 Health Survey (SF-36) at baseline and were divided into the living alone and living with others groups. Telephone follow-up was performed 1 year later to re-evaluate the SF-36. Differences in health status between and within groups were assessed. In addition, variables associated with changes in the health of the whole population were examined. RESULTS A total of 402 patients with OSA were enrolled, including 120 in the living alone group and the rest in the living with others group. After a year, mental health scores of the living alone group decreased (55.7 ± 21.5 versus 54.1 ± 22.7, p = 0.001), while physical functioning scores of the living with others group increased significantly (82.1 ± 24.7 versus 82.6 ± 24.2, p = 0.006). In the whole population, the determinants of mental health change after 1 year from baseline were alcohol drinking (beta coefficient - 1.169, 95% CI - 2.03 to - 0.309, p = 0.008) and solitary living (beta coefficient - 1.135, 95% CI - 2.072 to - 0.199, p = 0.018). CONCLUSION Regarding all initial variables, alcohol drinking and solitary living seem to be the predictors of mental health change of patients with OSA in China. We speculate that to improve the quality of life of such people, the medical staff could provide certain social support for them.
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Affiliation(s)
- Xuan Zhang
- Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Clinical Psychology, Capital Medical University, Beijing, China
| | - Yang Yang
- Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Shuo Wang
- Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Ping Yu
- Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Bo-Yuan Guan
- Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Chun-Xue Wang
- Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
- Department of Clinical Psychology, Capital Medical University, Beijing, China.
- Beijing Institute of Brain Disorders, Beijing, China.
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21
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Association of circadian rhythm with mild cognitive impairment among male pneumoconiosis workers in Hong Kong: a cross-sectional study. Sci Rep 2023; 13:1650. [PMID: 36717700 PMCID: PMC9885413 DOI: 10.1038/s41598-023-28832-5] [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: 03/31/2022] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Weakened circadian activity rhythms (CARs) were associated with mild cognitive impairment (MCI) in the general population. However, it remains unclear among pneumoconiosis patients. We aimed to address this knowledge gap. This cross-sectional study comprised 186 male pneumoconiosis patients (71.3 ± 7.8 years) and 208 healthy community men. Actigraphy was used to determine CARs parameters (percent rhythm, amplitude, MESOR, and acrophase). Values below the corresponding medians of the CARs parameters represented weakened CARs. The Cantonese version of Mini-Mental State Examination (CMMSE) was used to assess cognitive function, MCI, and the composite outcome of MCI plus cognitive impairment. Compared with the community referents, pneumoconiosis patients had worse cognition and dampened CARs. Compared with the community referents or pneumoconiosis patients with robust circadian rhythm, pneumoconiosis patients with weakened circadian rhythm were consistently associated with increased risk of MCI and the composite outcome. However, significant association was only observed between MESOR and the composite outcome (adjusted OR = 1.99, 95%: 1.04-3.81). A delayed phase of CARs was insignificantly associated with MCI and the composite outcome. Our findings showed that weakened CARs were associated with worse cognitive function among male pneumoconiosis workers. Intervention in improving CARs may mitigate cognitive deterioration in male pneumoconiosis workers.
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22
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Yu R, Lai D, Leung G, Tong C, Yuen S, Woo J. A Dyadic Cooking-Based Intervention for Improving Subjective Health and Well-Being of Older Adults with Subjective Cognitive Decline and Their Caregivers: A Randomized Controlled Trial. J Nutr Health Aging 2023; 27:824-832. [PMID: 37960905 DOI: 10.1007/s12603-023-1990-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/04/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES Evidence on the effectiveness of cooking activities as a well-being promotion intervention for older adults with subjective cognitive decline (SCD) and their caregivers is scarce. In view of this, a randomized controlled trial was conducted to examine whether a dyadic cooking-based intervention can improve the subjective health and well-being of older adults with SCD and their caregivers, as well as the cooking competence of the former group. DESIGN Randomized controlled trial. SETTING Community. PARTICIPANTS Sixty pairs of community-dwelling older adults aged 60 years or above with SCD (mean age = 78.4 years) and their caregivers (mean age = 65.3 years) were randomly assigned to the intervention group (N = 30 pairs) and the wait-list control group (N = 30 pairs). INTERVENTION The intervention was an innovative 5-week (two hours per week) dyadic cooking-based intervention employing procedural learning methods specifically adapted for older adults with SCD. MEASUREMENTS The outcome measures included 1) a well-being index composed by four indicators: life satisfaction, feeling of happiness, sense of purpose and meaning in life, and perceived health, and 2) cooking competence. RESULTS For both older adults with SCD and their caregivers, the increases in the well-being index were significantly greater in the intervention group than in the control group (β = 0.508, 95% CI [0.036, 0.980]). For older adults with SCD, the increases in the cooking competence score were significantly greater in the intervention group than in the control group (β = 1.629, 95% CI [0.165, 3.071]). CONCLUSION The dyadic cooking-based intervention resulted in improvements in the cooking competence and well-being of older adults with SCD, as well as the well-being of caregivers.
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Affiliation(s)
- R Yu
- Ruby Yu, Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong,
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23
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Zhang HQ, Chau ACM, Shea YF, Chiu PKC, Bao YW, Cao P, Mak HKF. Disrupted Structural White Matter Network in Alzheimer's Disease Continuum, Vascular Dementia, and Mixed Dementia: A Diffusion Tensor Imaging Study. J Alzheimers Dis 2023; 94:1487-1502. [PMID: 37424470 DOI: 10.3233/jad-230341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Dementia presents a significant burden to patients and healthcare systems worldwide. Early and accurate diagnosis, as well as differential diagnosis of various types of dementia, are crucial for timely intervention and management. However, there is currently a lack of clinical tools for accurately distinguishing between these types. OBJECTIVE This study aimed to investigate the differences in the structural white matter (WM) network among different types of cognitive impairment/dementia using diffusion tensor imaging, and to explore the clinical relevance of the structural network. METHODS A total of 21 normal control, 13 subjective cognitive decline (SCD), 40 mild cognitive impairment (MCI), 22 Alzheimer's disease (AD), 13 mixed dementia (MixD), and 17 vascular dementia (VaD) participants were recruited. Graph theory was utilized to construct the brain network. RESULTS Our findings revealed a monotonic trend of disruption in the brain WM network (VaD > MixD > AD > MCI > SCD) in terms of decreased global efficiency, local efficiency, and average clustering coefficient, as well as increased characteristic path length. These network measurements were significantly associated with the clinical cognition index in each disease group separately. CONCLUSION These findings suggest that structural WM network measurements can be utilized to differentiate between different types of cognitive impairment/dementia, and these measurements can provide valuable cognition-related information.
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Affiliation(s)
- Hui-Qin Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Anson C M Chau
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Medical Radiation Science, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Yat-Fung Shea
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Patrick Ka-Chun Chiu
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Yi-Wen Bao
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Medical Imaging Center, The Affiliated Huaian No.1 People's Hospital, Nanjing Medical University, Huai'an, China
| | - Peng Cao
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Henry Ka-Fung Mak
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Alzheimer's Disease Research Network, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Wang SM, Chan ST, Wong YL, Hsu HM, Lee CY, Check CY, Leung CK. Rhythmic auditory stimulation incorporated in training improved movements in individuals with psychotic-like experiences. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01524-3. [PMID: 36422679 DOI: 10.1007/s00406-022-01524-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022]
Abstract
Movement abnormalities, including movement slowing and irregular muscle contraction, exist in individuals with psychotic-like experiences (PLEs) and serve as vulnerable factors of developing psychotic diseases in the psychosis continuum. To date scarce studies have developed early intervention programs tackling these initial impairments, which may be caused by basal ganglia alterations, in the early stage of the psychosis course. Rhythmic auditory stimulation (RAS) is a technique of neurological music therapy and has been proved effective in inducing faster movements in patients with psychotic diseases. This pilot study examined if RAS incorporated in functional movement training reduced severity of movement slowing and irregular muscle contraction in individuals with PLEs. Seventeen individuals with PLEs were randomly allocated to receiving RAS or receiving no RAS and underwent daily 40-min movement training (picking up beans) for three weeks. This study used motion analysis to measure movement performance at pretest and posttest. Eighteen age- and gender-matched individuals without PLEs were also recruited to provide data of intact movements. Results showed that RAS may reduce severity of movement slowing and irregular muscle contraction in individuals with PLEs. This pilot study is one of the pioneering studies validating effectiveness of early intervention programs tackling movement abnormalities, which are initial impairments in the psychosis continuum, in individuals with PLEs.
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Affiliation(s)
- Shu-Mei Wang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong.
| | - Sin-Tung Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Yuk-Lin Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Hsiao-Man Hsu
- Clinical Medicine and Advanced Applied Research Department, Point Robotics Medtech Incorporation, New Taipei, Taiwan
| | - Cheuk-Yan Lee
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Chung-Yin Check
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
| | - Cheuk-Kiu Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong
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Ngan STJ, Chan LK, Chan WC, Lam LCW, Li WK, Lim K, Or E, Pang PF, Poon TK, Wong MCM, Wu YKA, Cheng PWC. High-definition transcranial direct current stimulation (HD-tDCS) as augmentation therapy in late-life depression (LLD) with suboptimal response to treatment-a study protocol for a double-blinded randomized sham-controlled trial. Trials 2022; 23:914. [PMID: 36307858 DOI: 10.1186/s13063-022-06855-z] [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: 04/13/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Late-life depression (LLD) has a poorer prognosis and higher relapse rate than younger adults, with up to one third of patients with LLD showing suboptimal response to antidepressant therapy. LLD has been associated with significant impairment in cognition and daily functioning. Few studies have evaluated the therapeutic effects of high-definition transcranial direct current stimulation (HD-tDCS) on depressive and cognitive symptoms of LLD. The current randomized controlled trial assesses the efficacy of HD-tDCS as an augmentation therapy with antidepressants compared to sham-control in subjects with LLD. METHODS Fifty-eight patients with LLD will be recruited and randomly assigned to the active HD-tDCS or sham HD-tDCS group. In both groups, patients will receive the active or sham intervention in addition to their pre-existing antidepressant therapy, for 2 weeks with 5 sessions per week, each lasting 30 min. The primary outcome measures will be the change of depressive symptoms, clinical response and the remission rate as measured with the Hamilton Depression Rating scale (HAMD-17) before and after the intervention, and at the 4th and 12th week after the completed intervention. Secondary outcome measures include cognitive symptoms, anxiety symptoms, daily functioning and adverse effects. DISCUSSION: Older adults with depression are associated with poorer outcomes or unsatisfactory responses to antidepressant therapy, and significant cognitive decline. Therefore, a new effective treatment option is needed. This randomized control trial aims at assessing the efficacy of HD-tDCS on ameliorating the depressive, cognitive and anxiety symptoms, and improving the daily functioning of subjects with LLD. TRIAL REGISTRATION ClinicalTrials.gov NCT05322863. Registered on 11 April 2022.
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Affiliation(s)
- Sze Ting Joanna Ngan
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Lap Kei Chan
- Department of Psychiatry, Kwai Chung Hospital, Kwai Chung, Hong Kong, Hong Kong
| | - Wai Chi Chan
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Tai Po Hospital, G/F, Multi-Centre, Tai Po, Hong Kong, Hong Kong
| | - Wan Kei Li
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Kelvin Lim
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ego Or
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Pui Fai Pang
- Department of Psychiatry, United Christian Hospital, Kwun Tong, Hong Kong, Hong Kong
| | - Ting Keung Poon
- Department of Psychiatry, Kowloon Hospital, Kadoorie Hill, Hong Kong, Hong Kong
| | - Mei Cheung Mimi Wong
- Department of Psychiatry, United Christian Hospital, Kwun Tong, Hong Kong, Hong Kong
| | - Ying King Anna Wu
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, Hong Kong
| | - Pak Wing Calvin Cheng
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong.
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26
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Gong X, Wong PCM, Fung HH, Mok VCT, Kwok TCY, Woo J, Wong KH, Meng H. The Hong Kong Grocery Shopping Dialog Task (HK-GSDT): A Quick Screening Test for Neurocognitive Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13302. [PMID: 36293882 PMCID: PMC9603616 DOI: 10.3390/ijerph192013302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/02/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The Hong Kong Grocery Shopping Dialog Task (HK-GSDT) is a short and easy-to-administer cognitive test developed for quickly screening neurocognitive disorders (NCDs). In the test, participants are instructed to do a hypothetical instrumental activity of daily living task of purchasing ingredients for a dish from a grocery store and verbally describe the specific shopping procedures. The current study aimed to validate the test with a sample of 545 Hong Kong older adults (58.8% female; aged 73.4 ± 8.37 years), including 464 adults with normal cognitive function, 39 with mild NCD, and 42 with major NCD. Demographic characteristics (i.e., sex, age, education) and clinical diagnosis of cognitive states (i.e., major NCD, mild NCD, and normal aging) were collected. Cognitive functioning was measured using the HK-GSDT and several standardized NCD-screening tests. The results showed good reliability (i.e., internal consistency) and structural validity in the HK-GSDT. It discriminated among different cognitive conditions, particularly between major NCDs and the other conditions, as effectively as did the existing standardized neurocognitive tests (e.g., Montreal Cognitive Assessment, Hong Kong List Learning Test). Moreover, the HK-GSDT explained additional variance of cognitive condition on top of those standardized neurocognitive tests. These results indicate that the HK-GSDT can be used alone, or in combination with other tests, to screen for NCDs.
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Affiliation(s)
- Xianmin Gong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick C. M. Wong
- Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Hong Kong, China
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Helene H. Fung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent C. T. Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Gerald Choa Neuroscience Centre, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy C. Y. Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club Institute of Aging, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Ho Wong
- Department of Systems Engineering and Engineering Management, The Chinese University of Hong Kong, Hong Kong, China
| | - Helen Meng
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, China
- Department of Systems Engineering and Engineering Management, The Chinese University of Hong Kong, Hong Kong, China
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Association between participation self-efficacy and participation in stroke survivors. BMC Neurol 2022; 22:361. [PMID: 36138370 PMCID: PMC9494797 DOI: 10.1186/s12883-022-02883-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most stroke survivors face restrictions in functional disability and social participation, which can impede their recovery and community reintegration. Participation self-efficacy refers to survivors' confidence in using strategies to manage participation in areas including community living and work engagement. This study aimed to assess the association between participation self-efficacy and participation among stroke survivors. METHODS This study adopted a cross-sectional correlational design with a convenience sample of 336 stroke survivors recruited from five hospitals in China. Participation self-efficacy was measured using the Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES-C) and participation measured using the Chinese version of the Reintegration to Normal Living Index (RNLI-C). The association between participation self-efficacy and participation was examined using multiple regression analysis with adjustment for potential confounders. RESULTS Participants had a mean age of 69.9 ± 11.5 years, with most (81.6%) having an ischaemic stroke, and more than half (61.6%) a first-ever stroke. After adjustment for potential confounders, every 10-point increase in the PS-SES-C total score was significantly associated with an average 1.3-point increase in the RNLI-C total score (B = 1.313, SE = 0.196, p < 0.001). CONCLUSIONS This study demonstrates that participation self-efficacy is significantly associated with participation among Chinese community-dwelling survivors of a mild or moderate stroke. This suggests that rehabilitation programmes for stroke survivors may be more effective if they incorporate participation-focused strategies designed to enhance self-efficacy. (229 words).
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Cheung EYW, Chau ACM, Shea YF, Chiu PKC, Kwan JSK, Mak HKF. Level of Amyloid-β (Aβ) Binding Leading to Differential Effects on Resting State Functional Connectivity in Major Brain Networks. Biomedicines 2022; 10:biomedicines10092321. [PMID: 36140422 PMCID: PMC9496530 DOI: 10.3390/biomedicines10092321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction: Amyloid-β protein (Aβ) is one of the biomarkers for Alzheimer’s disease (AD). The recent application of interhemispheric functional connectivity (IFC) in resting-state fMRI has been used as a non-invasive diagnostic tool for early dementia. In this study, we focused on the level of Aβ accumulated and its effects on the major functional networks, including default mode network (DMN), central executive network (CEN), salience network (SN), self-referential network (SRN) and sensory motor network (SMN). Methods: 58 participants (27 Hi Aβ (HiAmy) and 31 low Aβ (LowAmy)) and 25 healthy controls (HC) were recruited. [18F]flutemetamol PET/CT was performed for diseased groups, and MRI scanning was done for all participants. Voxel-by-voxel correlation analysis was done for both groups in all networks. Results: In HiAmy, IFC was reduced in all networks except SN. A negative correlation in DMN, CEN, SRN and SMN suggests high Aβ related to IFC reduction; However, a positive correlation in SN suggests high Aβ related to an increase in IFC. In LowAmy, IFC increased in CEN, SMN, SN and SRN. Positive correlation in all major brain networks. Conclusion: The level of Aβ accumulated demonstrated differential effects on IFC in various brain networks. As the treatment to reduce Aβ plaque deposition is available in the market, it may be an option for the HiAmy group to improve their IFC in major brain networks.
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Affiliation(s)
- Eva Y. W. Cheung
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- School of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong
- Correspondence: (E.Y.W.C.); (H.K.F.M.)
| | - Anson C. M. Chau
- Medical Radiation Science, Allied Health and Human Performance Unit, University of South Australia, City East Campus, Bonython Jubilee Building, 1-26, Adelaide, SA 5001, Australia
| | - Yat-Fung Shea
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Patrick K. C. Chiu
- Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Joseph S. K. Kwan
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Henry K. F. Mak
- Department of Diagnostic Radiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
- Alzheimer’s Disease Research Network, The University of Hong Kong, Hong Kong
- Correspondence: (E.Y.W.C.); (H.K.F.M.)
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Yu DJ, Yu AP, Bernal JDK, Fong DY, Chan DKC, Cheng CP, Siu PM. Effects of exercise intensity and frequency on improving cognitive performance in middle-aged and older adults with mild cognitive impairment: A pilot randomized controlled trial on the minimum physical activity recommendation from WHO. Front Physiol 2022; 13:1021428. [PMID: 36200056 PMCID: PMC9527311 DOI: 10.3389/fphys.2022.1021428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The World Health Organization physical activity guidelines recommend adults and older adults to accumulate at least 150–300 min of moderate or 75–150 min of vigorous aerobic-type physical activity weekly for health benefits including improvements of cognitive performance. However, the optimal exercise intensity and frequency for maximizing the cognitive benefits remain unclear. Purpose: We conducted a parallel, assessor-blinded, pilot randomized controlled trial to evaluate the effectiveness of different intensities and frequencies of the WHO-recommended minimal volume of aerobic-type physical activity on improving cognitive performance in middle-aged and older adults with mild cognitive impairment (MCI). Methods: Participants were randomly allocated to the stretching exercise control group (CON), once-a-week and thrice-a-week moderate-intensity walking groups (M1 and M3), and once-a-week and thrice-a-week vigorous-intensity walking groups (V1 and V3). Intervention duration was 12 weeks. The primary outcome was global cognitive performance assessed by the Hong Kong version of Montreal Cognitive Assessment. Secondary outcomes were self-report and objective cognitive performances, mental health, sleep quality, and cardiorespiratory fitness. Results: Thirty-seven participants completed the study (CON: n = 7, M1: n = 7, M3: n = 7, V1: n = 8, V3: n = 8). Participants in all four walking exercise groups demonstrated significant improvements in global cognitive performance assessed by the Hong Kong version of the Montreal Cognitive Assessment after the intervention when compared to CON (p < 0.001). The walking exercise interventions also significantly mitigated the anxiety severity (p < 0.005) and improved the cardiorespiratory fitness (p < 0.05) of the participants in the walking exercise groups. Conclusion: 150-min moderate- or 75-min vigorous-intensity walking exercise performed once- or thrice-weekly showed similar effects on improving cognitive performance in middle-aged and older adults with MCI. The 12-week walking exercise interventions also reduced anxiety severity and improved cardiorespiratory fitness of the participants. Clinical Trial Registration:clinicaltrials.gov, identifier NCT04515563
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Affiliation(s)
- Danny J. Yu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Angus P. Yu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Joshua D. K. Bernal
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Daniel Y. Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Derwin K. C. Chan
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Calvin P. Cheng
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Department of Psychiatry, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
| | - Parco M. Siu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- *Correspondence: Parco M. Siu,
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Kor PPK, Kwan RYC, Cheung DSK, Lai C. The utilization of a nurse-led clinic by older people with cognitive complaints: Do they follow our advice? Int J Nurs Pract 2022; 28:e13096. [PMID: 36003029 DOI: 10.1111/ijn.13096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 06/08/2022] [Accepted: 07/23/2022] [Indexed: 12/01/2022]
Abstract
AIM Cognitive assessment services were found to be beneficial to older people with cognitive complaints but information is limited on adherence to the recommendations provided. This study aimed to identify predictors of clients' adherence to nursing recommendations after attending a community-based nurse-led cognitive assessment service in Hong Kong. METHODS A cross-sectional design was adopted. We analysed a dataset routinely collected from clients attending the services between January 2012 and January 2018. Multiple regression analyses were conducted to identify predictors (demographics, functional health status and cognitive performance) of the clients' adherence. Their satisfaction with the services was also examined. RESULTS Two hundred and twenty-three clients attended the clinic. Of the 133 who completed the telephone follow-up at the 6 months postconsultation, 44.1% did not adhere to the recommendations. Clients with a higher Clinical Dementia Rating (OR = 4.17), lower Clock Drawing Test score (OR = 1.13) and lower education level (OR = 0.91) were found to be less likely to adhere to the nursing recommendations. Ninety-six percent (190/198) were satisfied with the overall services. CONCLUSION Cognitive assessment services in nurse-led clinics could provide a self-referred service for older people with cognitive complaints. However, low adherence to nursing recommendations was found among clients with poorer cognitive functions and lower education levels.
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Affiliation(s)
- Patrick Pui-Kin Kor
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | | | | | - Claudia Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, China
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Lu H, Chan SSM, Ma S, Lin C, Mok VCT, Shi L, Wang D, Mak AD, Lam LCW. Clinical and radiomic features for predicting the treatment response of repetitive transcranial magnetic stimulation in major neurocognitive disorder: Results from a randomized controlled trial. Hum Brain Mapp 2022; 43:5579-5592. [PMID: 35912517 PMCID: PMC9704797 DOI: 10.1002/hbm.26032] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 06/15/2022] [Accepted: 07/18/2022] [Indexed: 01/15/2023] Open
Abstract
Image-guided repetitive transcranial magnetic stimulation (rTMS) has shown clinical effectiveness in senior adults with co-occurring depression and cognitive impairment, yet the imaging markers for predicting the treatment response are less investigated. In this clinical trial, we examined the efficacy and sustainability of 10 Hz rTMS for the treatment of depression and cognitive impairment in major neurocognitive disorder (NCD) patients and tested the predictive values of imaging-informed radiomic features in response to rTMS treatment. Fifty-five major NCD patients with depression were randomly assigned to receive a 3-week rTMS treatment of either active 10 Hz rTMS (n = 27) or sham rTMS (n = 28). Left dorsolateral prefrontal cortex (DLPFC) was the predefined treatment target. Based on individual structural magnetic resonance imaging scans, surface-based analysis was conducted to quantitatively measure the baseline radiomic features of left DLPFC. Severity of depression, global cognition and the serum brain-derived neurotrophic factor (BDNF) level were evaluated at baseline, 3-, 6- and 12-week follow-ups. Logistic regression analysis revealed that advanced age, higher baseline cognition and randomized group were associated with the remission of depression. Increased cortical thickness and gyrification in left DLPFC were the significant predictors of clinical remission and cognitive enhancement. A 3-week course of 10 Hz rTMS is an effective adjuvant treatment for rapid ameliorating depressive symptoms and enhancing cognitive function. Pre-treatment radiomic features of the stimulation target can predict the response to rTMS treatment in major NCD. Cortical thickness and folding of treatment target may serve as imaging markers to detect the responders. ChiCTR-IOR-16008191, registered on March 30, 2016.
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Affiliation(s)
- Hanna Lu
- Department of PsychiatryThe Chinese University of Hong KongHong Kong SARChina,The Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhouChina
| | - Sandra Sau Man Chan
- Department of PsychiatryThe Chinese University of Hong KongHong Kong SARChina
| | - Sukling Ma
- Department of PsychiatryThe Chinese University of Hong KongHong Kong SARChina
| | - Cuichan Lin
- Department of PsychiatryThe Chinese University of Hong KongHong Kong SARChina
| | - Vincent Chung Tong Mok
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong Kong SARChina
| | - Lin Shi
- Department of Imaging and Interventional RadiologyThe Chinese University of Hong KongHong Kong SARChina
| | - Defeng Wang
- Department of Imaging and Interventional RadiologyThe Chinese University of Hong KongHong Kong SARChina
| | - Arthur Dun‐Ping Mak
- Department of PsychiatryThe Chinese University of Hong KongHong Kong SARChina
| | - Linda Chiu Wa Lam
- Department of PsychiatryThe Chinese University of Hong KongHong Kong SARChina
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Bao YW, Shea YF, Chiu PKC, Kwan JSK, Chan FHW, Chow WS, Chan KH, Mak HKF. The fractional amplitude of low-frequency fluctuations signals related to amyloid uptake in high-risk populations—A pilot fMRI study. Front Aging Neurosci 2022; 14:956222. [PMID: 35966783 PMCID: PMC9372772 DOI: 10.3389/fnagi.2022.956222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPatients with type 2 diabetes mellitus (T2DM) and subjective cognitive decline (SCD) have a higher risk to develop Alzheimer's Disease (AD). Resting-state-functional magnetic resonance imaging (rs-fMRI) was used to document neurological involvement in the two groups from the aspect of brain dysfunction. Accumulation of amyloid-β (Aβ) starts decades ago before the onset of clinical symptoms and may already have been associated with brain function in high-risk populations. However, this study aims to compare the patterns of fractional amplitude of low-frequency fluctuations (fALFF) maps between cognitively normal high-risk groups (SCD and T2DM) and healthy elderly and evaluate the association between regional amyloid deposition and local fALFF signals in certain cortical regions.Materials and methodsA total of 18 T2DM, 11 SCD, and 18 healthy elderlies were included in this study. The differences in the fALFF maps were compared between HC and high-risk groups. Regional amyloid deposition and local fALFF signals were obtained and further correlated in two high-risk groups.ResultsCompared to HC, the altered fALFF signals of regions were shown in SCD such as the left posterior cerebellum, left putamen, and cingulate gyrus. The T2DM group illustrated altered neural activity in the superior temporal gyrus, supplementary motor area, and precentral gyrus. The correlation between fALFF signals and amyloid deposition was negative in the left anterior cingulate cortex for both groups. In the T2DM group, a positive correlation was shown in the right occipital lobe and left mesial temporal lobe.ConclusionThe altered fALFF signals were demonstrated in high-risk groups compared to HC. Very early amyloid deposition in SCD and T2DM groups was observed to affect the neural activity mainly involved in the default mode network (DMN).
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Affiliation(s)
- Yi-Wen Bao
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yat-Fung Shea
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | | | - Joseph S. K. Kwan
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Felix Hon-Wai Chan
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Wing-Sun Chow
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Koon-Ho Chan
- Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Henry Ka-Fung Mak
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Henry Ka-Fung Mak
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Incremental diagnostic value of 18F-Fluetemetamol PET in differential diagnoses of Alzheimer's Disease-related neurodegenerative diseases from an unselected memory clinic cohort. Sci Rep 2022; 12:10385. [PMID: 35725910 PMCID: PMC9209498 DOI: 10.1038/s41598-022-14532-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/08/2022] [Indexed: 11/08/2022] Open
Abstract
To evaluate the incremental diagnostic value of 18F-Flutemetamol PET following MRI measurements on an unselected prospective cohort collected from a memory clinic. A total of 84 participants was included in this study. A stepwise study design was performed including initial analysis (based on clinical assessments), interim analysis (revision of initial analysis post-MRI) and final analysis (revision of interim analysis post-18F-Flutemetamol PET). At each time of evaluation, every participant was categorized into SCD, MCI or dementia syndromal group and further into AD-related, non-AD related or non-specific type etiological subgroup. Post 18F-Flutemetamol PET, the significant changes were seen in the syndromal MCI group (57%, p < 0.001) involving the following etiological subgroups: AD-related MCI (57%, p < 0.01) and non-specific MCI (100%, p < 0.0001); and syndromal dementia group (61%, p < 0.0001) consisting of non-specific dementia subgroup (100%, p < 0.0001). In the binary regression model, amyloid status significantly influenced the diagnostic results of interim analysis (p < 0.01). 18F-Flutemetamol PET can have incremental value following MRI measurements, particularly reflected in the change of diagnosis of individuals with unclear etiology and AD-related-suspected patients due to the role in complementing AD-related pathological information.
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Ho HC, Cheng W, Song Y, Liu Y, Guo Y, Lu S, Lum TYS, Chiu R, Webster C. Spatial uncertainty and environment-health association: An empirical study of osteoporosis among "old residents" in public housing estates across a hilly environment. Soc Sci Med 2022; 306:115155. [PMID: 35750005 DOI: 10.1016/j.socscimed.2022.115155] [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: 06/10/2021] [Revised: 04/13/2022] [Accepted: 06/14/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Built environment can influence physical conditions of older adults (e.g. osteoporosis). However, traditional methods using 2-dimensional circular buffer as a spatial structure to measure neighbourhood effect may create bias in health estimation, especially for the hilly and compact environment across low-income neighbourhoods (e.g. public housing estates). METHODS We evaluated the environmental influences on self-reported osteoporosis among "old residents" (age≥65) in Hong Kong (n = 2077). Twelve public housing estates across hilly neighbourhoods in Hong Kong were selected as study sites. A cross-validated approach was developed to evaluate four spatial structures (2D circular, 2D service area, 3D circular, 3D service area). To determine problems of spatial uncertainty, we compared odds ratios (OR) and differences in effect sizes from models using different spatial structures. When all adjusted models achieve significant results based on 95% confidence intervals (CI) and with all positive/negative ORs, this study reported to have reached "a result with consistency". Results from the 3D service area were then used to explain the environment-health relationship. RESULTS Different spatial structures can yield different results. Particularly, circular buffers overestimated environmental effects on self-reported osteoporosis. Overestimated measures were related to walkability and accessibility but not greenery. Specifically, results from the 3D service area showed that more public space and health facilities within a walkable distance (500 m) from a location of subject's residence were negatively associated with self-reported osteoporosis (adjusted ORs: 0.44 [0.29, 0.66]; 0.94 [0.90, 0.99]). However, more major transport facilities at the immediate distance from residence (200 m) was positively associated with self-reported osteoporosis (adjusted OR: 1.11 [1.01, 1.23]). CONCLUSIONS Physical conditions (e.g. osteoporosis) of older adults living in a hilly neighbourhood could be driven by walking behaviours. It is necessary to include local terrain and road network to define a walkable neighbourhood for environment-health estimations to minimize spatial bias.
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Affiliation(s)
- Hung Chak Ho
- Healthy High Density Cities Lab, The University of Hong Kong, Hong Kong; Department of Urban Planning and Design, The University of Hong Kong, Hong Kong; Department of Anaesthesiology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Wei Cheng
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong
| | - Yimeng Song
- School of the Environment, Yale University, New Haven, CT, 06511, Unites States
| | - Yuqi Liu
- Department of Urban Planning, School of Architecture, South China University of Technology, Guangzhou, China
| | - Yingqi Guo
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Shiyu Lu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Terry Yat Sang Lum
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Rebecca Chiu
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong
| | - Chris Webster
- Healthy High Density Cities Lab, The University of Hong Kong, Hong Kong; Faculty of Architecture, The University of Hong Kong, Hong Kong.
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Han Y, Quan X, Chuang Y, Liang Q, Li Y, Yuan Z, Bian Y, Wei L, Wang J, Zhao Y. A multi-omics analysis for the prediction of neurocognitive disorders risk among the elderly in Macao. Clin Transl Med 2022; 12:e909. [PMID: 35696554 PMCID: PMC9191869 DOI: 10.1002/ctm2.909] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Due to the increasing ageing population, neurocognitive disorders (NCDs) have been a global public health issue, and its prevention and early diagnosis are crucial. Our previous study demonstrated that there is a significant correlation between specific populations and NCDs, but the biological characteristics of the vulnerable group predispose to NCDs are unclear. The purpose of this study is to investigate the predictors for the vulnerable group by a multi-omics analysis. METHODS Multi-omics approaches, including metagenomics, metabolomic and proteomic, were used to detect gut microbiota, faecal metabolites and urine exosome of 8 normal controls and 13 vulnerable elders after a rigorous screening of 400 elders in Macao. The multi-omics data were analysed using R and Bioconductor. The two-sided Wilcoxon's rank-sum test, Kruskal-Wallis rank sum test and the linear discriminant analysis effective size were applied to investigate characterized features. Moreover, a 2-year follow-up was conducted to evaluate cognitive function change of the elderly. RESULTS Compared with the control elders, the metagenomics of gut microbiota showed that Ruminococcus gnavus, Lachnospira eligens, Escherichia coli and Desulfovibrio piger were increased significantly in the vulnerable group. Carboxylates, like alpha-ketoglutaric acid and d-saccharic acid, and levels of vitamins had obvious differences in the faecal metabolites. There was a distinct decrease in the expression of eukaryotic translation initiation factor 2 subunit 1 (eIF2α) and amine oxidase A (MAO-A) according to the proteomic results of the urine exosomes. Moreover, the compound annual growth rate of neurocognitive scores was notably decreased in vulnerable elders. CONCLUSIONS The multi-omics characteristics of disturbed glyoxylate and dicarboxylate metabolism (bacteria), vitamin digestion and absorption and tricarboxylic acid cycle in vulnerable elders can serve as predictors of NCDs risk among the elderly of Macao. Intervention with them may be effective therapeutic approaches for NCDs, and the underlying mechanisms merit further exploration.
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Affiliation(s)
- Yan Han
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
| | - Xingping Quan
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
| | | | - Qiaoxing Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat‐sen UniversityGuangzhouChina
| | - Yang Li
- Department of Gastrointestinal SurgerySecond Clinical Medical College of Jinan University, Shenzhen People's HospitalShenzhenChina
| | - Zhen Yuan
- Centre for Cognitive and Brain SciencesUniversity of MacauTaipaMacao SARChina
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
| | - Lai Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat‐sen UniversityGuangzhouChina
| | - Ji Wang
- School of Traditional Chinese MedicineBeijing University of Chinese MedicineBeijingChina
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
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Kor PPK, Yu CTK, Liu JYW, Cheung DSK, Kwan RYC, Leung AYM, Liu DPM, Hon JMK. Pilot evaluation of a home-based multi-sensory cognitive stimulation intervention for older people with dementia and caregiver dyads during the COVID-19 pandemic. Int J Older People Nurs 2022; 17:e12471. [PMID: 35581672 PMCID: PMC9347533 DOI: 10.1111/opn.12471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 01/04/2022] [Accepted: 04/13/2022] [Indexed: 01/08/2023]
Affiliation(s)
- Patrick Pui Kin Kor
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Clare Tsz Kiu Yu
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Justina Yat Wa Liu
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Daphne Sze Ki Cheung
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | | | - Angela Yee Man Leung
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Denise Pik Mei Liu
- Ming Yue District Elderly Community CentreHong Kong Young Women's Christian AssociationHong Kong SARChina
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Poon PKM, Tam KW, Zhang D, Yip BHK, Woo J, Wong SYS. Handgrip strength but not SARC-F score predicts cognitive impairment in older adults with multimorbidity in primary care: a cohort study. BMC Geriatr 2022; 22:342. [PMID: 35440016 PMCID: PMC9020051 DOI: 10.1186/s12877-022-03034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Assessing motor function is a simple way to track cognitive impairment. We analysed the associations between cognitive and motor function and assessed the predictive value of two motor function measuring tools for cognitive impairment in older adults with multimorbidity in primary care settings. Methods We conducted a prospective cohort study with a 1 year follow-up. Patients aged ≥60 years with ≥2 morbidities were recruited from four primary care clinics. Motor function was assessed using handgrip strength and a sarcopenia screening scale (SARC-F). Cognitive function was measured using the Hong Kong Montreal Cognitive Assessment (HK-MoCA). We defined cognitive impairment as an HK-MoCA score < 22. The associations between cognitive and motor functions were examined from a bidirectional perspective. Results We included 477 participants (mean age 69.4, 68.6% female) with a mean (SD) HK-MoCA score of 25.5 (3.38), SARC-F score of 1.1 (1.36), and handgrip strength of 21.2 (6.99) kg at baseline. Multivariable linear regression models showed bidirectional cross-sectional associations of the HK-MoCA score and cognitive impairment with SARC-F score and handgrip strength at baseline and 1 year. Cox regression revealed a longitudinal association between baseline handgrip strength and cognitive impairment at 1 year (hazard ratio: 0.48, 95% CI 0.33–0.69) but no longitudinal association between SARC-F and cognitive impairment. Variation in the SARC-F score increased with decreasing HK-MoCA score (Brown–Forsythe test F statistic = 17.9, p < 0.001), while variability in the handgrip strength remained small (modified signed-likelihood ratio test, p < 0.001). Conclusions Primary healthcare providers may use handgrip strength to track cognitive function decline in older adults with multimorbidity. However, the SARC-F scale may not have the same predictive value. Further research is needed to evaluate the performance and variability of the SARC-F score in individuals with poor cognitive function. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03034-2.
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Affiliation(s)
- Paul Kwok Ming Poon
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - King Wa Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Benjamin Hon Kei Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Samuel Yeung Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Lai FHY, Tong AYC, Fung AWT, Yu KKY, Wong SSL, Lai CYY, Man DWK. Information Communication Technology as Instrumental Activities of Daily Living for Aging-in-Place in Chinese Older Adults With and Without Cognitive Impairment: The Validation Study of Advanced Instrumental Activities of Daily Living Scale. Front Neurol 2022; 13:746640. [PMID: 35356457 PMCID: PMC8959306 DOI: 10.3389/fneur.2022.746640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background The capability in applying information communication technology (ICT) is crucial to the functional independence of older peoples of community living nowadays. The proper assessment of individuals' capability of ICT application is the corner stone for the future development of telemedicine in our aging population. Methods With the recruitment of 300 participants of different functional and social background in home-living, hostel-living, and care-and-attention home living; and through assessing the ability of individuals in instrumental activities of daily living and cognitive assessments, this study aimed at capturing the content validity and construct validity of the Advanced Instrumental Activities of Daily Living (AIADL scale). In addition, this study assess the ability of older peoples in applying ICT and how the functional and social background affects their independence in aging-in-place. Results The AIADL scale showed good test-retest reliability and good-to-excellent internal consistency. To determine if items of the AIADL scale measure various aspects of community living, exploratory factor analysis revealed a two-factor structure with “home living and management” and “community living”. Validity analysis with the known-groups method showed a high overall accuracy of prediction of individuals' capability of independent living in the community. Conclusions The AIADL scale is a valid and reliable instrument to assess the ability of older adults in handling ICT as part of their instrumental activities in daily living. The scale can reflect capability of older peoples in applying ICT. This instrument can serve as a reference in measuring readiness of individuals in receiving telemedicine and their ability of aging-in-place.
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Affiliation(s)
- Frank Ho-yin Lai
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
- *Correspondence: Frank Ho-yin Lai
| | - Angela Yuk-chung Tong
- Occupational Therapy Department, West Kowloon General Out-Patient Clinic, Hong Kong, Hong Kong SAR, China
| | - Ada Wai-tung Fung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Kathy Ka-ying Yu
- Salvation Army Hong Kong and Macau Command, Tai Po Multi-Service Centre for Senior Citizen, Hong Kong, Hong Kong SAR, China
| | - Sharon Sui-lam Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Cynthia Yuen-yi Lai
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - David Wai-kwong Man
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Fong MCM, Ma MKH, Chui JYT, Law TST, Hui NY, Au A, Wang WS. Foreign Language Learning in Older Adults: Anatomical and Cognitive Markers of Vocabulary Learning Success. Front Hum Neurosci 2022; 16:787413. [PMID: 35340542 PMCID: PMC8942782 DOI: 10.3389/fnhum.2022.787413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/08/2022] [Indexed: 12/03/2022] Open
Abstract
In recent years, foreign language learning (FLL) has been proposed as a possible cognitive intervention for older adults. However, the brain network and cognitive functions underlying FLL has remained largely unconfirmed in older adults. In particular, older and younger adults have markedly different cognitive profile—while older adults tend to exhibit decline in most cognitive domains, their semantic memory usually remains intact. As such, older adults may engage the semantic functions to a larger extent than the other cognitive functions traditionally considered the most important (e.g., working memory capacity and phonological awareness). Using anatomical measurements and a cognitive test battery, the present study examined this hypothesis in twenty cognitively normal older adults (58–69 years old), who participated in a two-month Italian learning programme. Results showed that the immediate learning success and long-term retention of Italian vocabularies were most consistently predicted by the anatomical measures of the left pars orbitalis and left caudal middle frontal cortex, which are implicated in semantic and episodic memory functions. Convergent evidence was also found based on the pattern of cognitive associations. Our results are consistent with a prominent role of semantic and episodic memory functions in vocabulary learning in older learners.
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Affiliation(s)
- Manson Cheuk-Man Fong
- Research Centre for Language, Cognition, and Neuroscience, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- *Correspondence: Manson Cheuk-Man Fong
| | - Matthew King-Hang Ma
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jeremy Yin To Chui
- Research Centre for Language, Cognition, and Neuroscience, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Tammy Sheung Ting Law
- Research Centre for Language, Cognition, and Neuroscience, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Nga-Yan Hui
- Research Centre for Language, Cognition, and Neuroscience, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Alma Au
- Department of Applied Social Science, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - William Shiyuan Wang
- Research Centre for Language, Cognition, and Neuroscience, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- William Shiyuan Wang
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Tsang CSL, Miller T, Pang MYC. Association between fall risk and assessments of single-task and dual-task walking among community-dwelling individuals with chronic stroke: A prospective cohort study. Gait Posture 2022; 93:113-118. [PMID: 35134650 DOI: 10.1016/j.gaitpost.2022.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 12/21/2021] [Accepted: 01/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Falling and fall-related injuries are common among community-dwelling individuals with chronic stroke. Falls often occur during dual-task walking scenarios. Accurate fall prediction is critical for formulating effective fall prevention strategies. RESEARCH QUESTIONS Can dual-task walking tests and corresponding single-task tests predict falls among individuals with chronic stroke? Are dual-task walking tests involving visuospatial cognition more effective in predicting falls than those involving other cognitive domains? METHODS Ninety-three individuals with stroke (age: 62.4 ± 6.7 years; stroke duration: 5.6 ± 4.5 years) participated in this prospective cohort study. Two mobility tasks (level-ground walking and obstacle-crossing) were performed with and without two cognitive tasks (auditory clock test and auditory Stroop test). Demographic information and clinical measures of depression, motor function, walking speed and balance were collected. Monthly telephone interviews were conducted to collect data on fall incidence, related circumstances and injuries incurred during a 12-month follow-up period. Multivariate logistic regression analysis was performed to identify predictive factors associated with future risk of falls. RESULTS Thirty-six participants (39%) reported one or more falls during the follow-up period. The regression model including reaction time during the auditory clock task performance while negotiating obstacles correctly classified the fall status of 80% of the participants (72% future fallers and 84% non-fallers). Performance did not differ between fallers and non-fallers on any other measures tested. SIGNIFICANCE Dual-task assessment combining an auditory clock task with an obstacle-crossing task has potential clinical utility for identifying future fall risk among people with chronic stroke.
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Affiliation(s)
- Charlotte S L Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Tiev Miller
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
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Jiang S, Cui J, Zhang LQ, Liu Z, Zhang Y, Shi Y, Cai JP. Role of a Urinary Biomarker in the Common Mechanism of Physical Performance and Cognitive Function. Front Med (Lausanne) 2022; 9:816822. [PMID: 35252255 PMCID: PMC8894651 DOI: 10.3389/fmed.2022.816822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionHealthy aging is described as a process of developing and maintaining intrinsic abilities, including physical and cognitive functions. Although oxidative stress is a common mechanism shared by loss of muscle strength and dementia, its relationship with decreased physical performance and cognitive impairment remains unclear. We aimed to investigate the role of urinary 8-oxo-7, 8-dihydroguanosine (8-oxoGsn), a biomarker of oxidative damage to RNA, in physical and cognitive decline.MethodsThe study followed a cross-sectional design and recruited 40–94-year-old inhabitants of Beijing, China (471 men and 881 women). The physical performance of the participants was assessed using handgrip strength, walking speed, and the repeated chair stand test. The cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) 5-min protocol. Urinary 8-oxoGsn levels were measured for all participants.ResultsParticipants with high urinary 8-oxoGsn levels were more likely to have low grip strength, slow walking speed, poor performance in the repeated chair stand test, and low scores on the MoCA 5-min protocol (odds ratio [OR] 3.43, 95% confidence interval [CI]: 1.52–7.76; OR 1.71, 95% CI: 1.16–2.53; OR 2.06, 95% CI: 0.92–4.63; OR 1.75, 95% CI: 1.18–2.58), after adjusting for age, sex, smoking habits, alcohol consumption, hypertension, diabetes, cerebro-cardiovascular disease, and chronic kidney disease.ConclusionElevated levels of oxidative stress are independently associated with cognitive and physical impairment. Thus, these results can help in the early identification and development of strategies for the prevention and treatment of intrinsic capacity decline.
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Affiliation(s)
- Shan Jiang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, Beijing, China
- National Center of Gerontology, National Health Commission, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ju Cui
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, Beijing, China
- National Center of Gerontology, National Health Commission, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Li-Qun Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, Beijing, China
- National Center of Gerontology, National Health Commission, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhen Liu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, Beijing, China
- National Center of Gerontology, National Health Commission, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, Beijing, China
- National Center of Gerontology, National Health Commission, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuan Shi
- Department of Geriatric Medicine, Longtan Community Health Service Center, Beijing, China
| | - Jian-Ping Cai
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, Beijing, China
- National Center of Gerontology, National Health Commission, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Jian-Ping Cai
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Zhang Z, Zhao Y, Bian Y. A Role of Socioeconomic Status in Cognitive Impairment Among Older Adults in Macau: A Decomposition Approach. Front Aging Neurosci 2022; 14:804307. [PMID: 35211006 PMCID: PMC8862725 DOI: 10.3389/fnagi.2022.804307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/13/2022] [Indexed: 12/25/2022] Open
Abstract
Background To explore the prevalence and inequality of cognitive impairment among older adults in Macau and the contributions of influencing factors to inequality in cognitive impairment. Methods The Montreal Cognitive Assessment (MoCA) was used to measure the prevalence of cognitive impairment. Socioeconomic status scores were used to describe economic level of the subjects. The concentration index was applied to measure the inequality of cognitive impairment associated with socioeconomic status (SES) and decomposed into its influencing factors. Results The prevalence of cognitive impairment was 44.35% in Macau. The concentration index of cognitive impairment among the elderly was −0.165 (95% CI: −0.232 to −0.098), indicating that the prevalence of cognitive impairment was concentrated in households with poor SES. Older age, poor SES, long or short sleep duration, other marital status, poor appetite, no tea/coffee drinking, no religious belief, and depression contributed positively to the inequality of cognitive impairment. Among these factors, SES made the largest contribution to inequality, accounting for 76.74%. Conclusion In Macau, the prevalence of cognitive impairment among people aged 65 years and older is concentrated among those who are in poor economic conditions. Reducing the gap between the rich and the poor at the source, increasing educational level of low SES population and improving their access to healthcare services will help to improve the inequity of cognitive impairment.
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Affiliation(s)
- Zhuo Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China
- School of Health Services Management, Xi’an Medical University, Xi’an, China
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China
- Yonghua Zhao,
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China
- *Correspondence: Ying Bian,
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Wong JYH, Choi AWM, Wong JKS, Ng ZLH, Cheung KY, Lau CL, Kam CW, Fong DYT. Impact of mild traumatic brain injury on physical, mental and cognitive functioning of abused women admitted to emergency units. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e428-e434. [PMID: 33159412 DOI: 10.1111/hsc.13218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/29/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023]
Abstract
Limited studies exist on women's mild traumatic brain injury received from episode of intimate partner violence. This study aims to identify the occurrence of intimate partner violence-related mild traumatic brain injury in Chinese women admitted to emergency units; and examine the physical, mental, and cognitive functioning of abused women with mild traumatic brain injury related to violent episodes. Eighty-six Chinese abused women presenting at emergency units in four major local hospitals in Hong Kong between January 2014 and December 2016 were recruited. They were admitted for the treatment of intimate partner violence-related physical injuries and were screened for traumatic brain injury by the emergency unit nurses at triage. Participants were assessed for traumatic brain injury based on the definition from US Center for Disease Control and Prevention, post-concussion physical symptoms, anxiety and depression, health-related quality of life, and cognitive functioning. Structured multiphase regression was used to examine the impact of intimate partner violence-related mild traumatic brain injury on physical, mental, and cognitive functioning of participants. We found that 24.4% of participants had intimate partner violence-related mild traumatic brain injury. There were significantly more severe post-concussion physical symptoms in abused women with intimate partner violence-related mild traumatic brain injury than those without mild traumatic brain injury (estimate = 18.7, 95% CI = 10.9 to 26.6, p < 0.001). The Mental Component Summary was also significantly associated with intimate partner violence-related mild traumatic brain injury (estimate = -7.9, 95% CI = -13.8 to -2.1, p = 0.009). Regarding cognitive functioning, the mean total test scores indicated that both groups were cognitively abnormal and there was no significant impact from mild traumatic brain injury. This study provides evidence on the impact of mild traumatic brain injury and implications in screening for mild traumatic brain injury and early intervention for improving quality of life in abused women.
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Affiliation(s)
- Janet Yuen-Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong S.A.R
| | - Anna Wai-Man Choi
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong S.A.R
| | - John Kit-Shing Wong
- Department of Accident and Emergency Medicine, Tuen Mun Hospital, Hospital Authority of Hong Kong, Hong Kong S.A.R
| | - Zoe Lai-Han Ng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong S.A.R
| | - Kai-Yeung Cheung
- Accident and Emergency Department, United Christian Hospital, Hospital Authority of Hong Kong, Hong Kong S.A.R
| | - Chu-Leung Lau
- Department of Accident and Emergency Medicine, Tuen Mun Hospital, Hospital Authority of Hong Kong, Hong Kong S.A.R
| | - Chak-Wah Kam
- Department of Accident and Emergency Medicine, Tuen Mun Hospital, Hospital Authority of Hong Kong, Hong Kong S.A.R
| | - Daniel Yee-Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong S.A.R
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Chen Y, Wong LLN, Chan SS, Yu J. Speech Perception in Noise Is Associated With Different Cognitive Abilities in Chinese-Speaking Older Adults With and Without Hearing Aids. Front Psychol 2022; 12:640300. [PMID: 35058826 PMCID: PMC8764161 DOI: 10.3389/fpsyg.2021.640300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid (HA) user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions (measured as audiometric or speech reception thresholds) in older Chinese adults with HAs and with untreated hearing loss (HL). Participants were 49 Chinese older adults who used HAs and had moderate to severe HL (HA group), and 46 older Chinese who had mild to moderately severe HL but did not use HAs (untreated; or UT group). Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9–21% of the variance in general cognitive function and verbal learning in the HA group (i.e., medium effect sizes). Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL.
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Affiliation(s)
- Yuan Chen
- Department of Special Education and Counseling, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
| | - Lena L N Wong
- Clinical Hearing Sciences (CHearS) Laboratory, Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Shaina Shing Chan
- Clinical Hearing Sciences (CHearS) Laboratory, Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Joannie Yu
- Audiology Centre, Union Hospital, Tai Wai, Hong Kong SAR, China
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Khan G, Mirza N, Waheed W. Developing guidelines for the translation and cultural adaptation of the Montreal Cognitive Assessment: scoping review and qualitative synthesis. BJPsych Open 2022; 8:e21. [PMID: 34991771 PMCID: PMC8811786 DOI: 10.1192/bjo.2021.1067] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Ethnic minorities in countries such as the UK are at increased risk of dementia or minor cognitive impairment. Despite this, cognitive tests used to provide a timely diagnosis for these conditions demonstrate performance bias in these groups, because of cultural context. They require adaptation that accounts for language and culture beyond translation. The Montreal Cognitive Assessment (MoCA) is one such test that has been adapted for multiple cultures. AIMS We followed previously used methodology for culturally adapting cognitive tests to develop guidelines for translating and culturally adapting the MoCA. METHOD We conducted a scoping review of publications on different versions of the MoCA. We extracted their translation and cultural adaptation procedures. We also distributed questionnaires to adaptors of the MoCA for data on the procedures they undertook to culturally adapt their respective versions. RESULTS Our scoping review found 52 publications and highlighted seven steps for translating the MoCA. We received 17 responses from adaptors on their cultural adaptation procedures, with rationale justifying them. We combined data from the scoping review and the adaptors' feedback to form the guidelines that state how each question of the MoCA has been previously adapted for different cultural contexts and the reasoning behind it. CONCLUSIONS This paper details our development of cultural adaptation guidelines for the MoCA that future adaptors can use to adapt the MoCA for their own languages or cultures. It also replicates methods previously used and demonstrates how these methods can be used for the cultural adaptation of other cognitive tests.
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Affiliation(s)
- Ghazn Khan
- Centre for Primary Care and Health Services Research, The University of Manchester, UK
| | - Nadine Mirza
- Centre for Primary Care and Health Services Research, The University of Manchester, UK
| | - Waquas Waheed
- Centre for Primary Care and Health Services Research, The University of Manchester, UK
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Wang SM, Ouyang WC, Hsu HM, Hsu LT. An Instrumental Measure of Hand and Facial Movement Abnormalities in Patients With Schizophrenia. Front Psychiatry 2022; 13:803661. [PMID: 35308887 PMCID: PMC8931260 DOI: 10.3389/fpsyt.2022.803661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Movement disorders have been suggested to be a cardinal component of schizophrenia. With increased research interests in this area, instrumental measures are needed. This study was to examine if the motion capture system was reliable in measuring hand and facial bradykinesia and dyskinesia and more sensitive to detecting movement differences between schizophrenia patients and healthy people than traditional rating scales. METHODS Sixteen schizophrenia patients and 20 control subjects were recruited. Hand and facial bradykinesia and dyskinesia were measured using the motion capture system and rated using the Extrapyramidal Symptom Rating Scale and the Abnormal Involuntary Movement Scale. RESULTS The system showed strong test-retest reliability and generated larger effect sizes of group differences than did the rating scales. CONCLUSIONS The results may support researchers and clinical practitioners to apply the system to sensitively measuring the hand and facial movement symptoms in schizophrenia patients, which contributes to gaining a deep understanding of movement issues in schizophrenia.
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Affiliation(s)
- Shu-Mei Wang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.,Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiao-Man Hsu
- Institute of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Li-Ta Hsu
- Department of Aeronautical and Aviation Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Regularity and randomness in ageing: Differences in resting-state EEG complexity measured by largest Lyapunov exponent. NEUROIMAGE: REPORTS 2021. [DOI: 10.1016/j.ynirp.2021.100054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Predictors of health-related quality of life after completion of chemotherapy among Malaysian early-stage breast cancer survivors. Support Care Cancer 2021; 30:2793-2801. [PMID: 34841453 DOI: 10.1007/s00520-021-06686-9] [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: 05/04/2021] [Accepted: 11/07/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Health-related quality of life (QoL) is an important outcome measure in breast cancer management. Evidence of QoL of breast cancer patients in lower and middle-income countries remains scarce. We examined the level of QoL, cognitive impairment, psychological distresses, and the predictors of QoL among multiethnic Malaysian early-stage breast cancer survivors 1 to 3 years following chemotherapy. METHODS A total of 160 breast cancer survivors from the University of Malaya Medical Centre (UMMC) participated in this cross-sectional study. Their QoL was evaluated with the Malay version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) version 3.0. Cognitive functioning and psychological distress were evaluated using the Malay version of the Montreal Cognitive Assessment (MoCA-BM) and Hospital Anxiety and Depression Scale (HADS), respectively. Data analysis was performed with Pearson's correlation and multiple regression analyses. RESULTS At 1- to 3-year post-chemotherapy, the mean EORTC QLQ-C30 global health status of the breast cancer survivors was relatively low (60.5 over 100, SD = 10.88). One-third (31.9%) of them demonstrated cognitive impairment, and another 3.2% showed moderate to severe anxiety levels. The significant predictors for global health status and functioning included age, psychological distresses, cognitive performance, fatigue, appetite loss, insomnia, pain, and constipation. CONCLUSION Our breast cancer survivors demonstrated poor global health status. Health care providers and policymakers must strive to provide holistic intervention strategies to improve the multiple dimensions of QoL and the cognitive and psychological functioning of this vulnerable population.
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Relationship between Amyloid-β Deposition and the Coupling between Structural and Functional Brain Networks in Patients with Mild Cognitive Impairment and Alzheimer's Disease. Brain Sci 2021; 11:brainsci11111535. [PMID: 34827535 PMCID: PMC8615711 DOI: 10.3390/brainsci11111535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023] Open
Abstract
Previous studies have demonstrated that the accumulation of amyloid-β (Aβ) pathologies has distinctive stage-specific effects on the structural and functional brain networks along the Alzheimer's disease (AD) continuum. A more comprehensive account of both types of brain network may provide a better characterization of the stage-specific effects of Aβ pathologies. A potential candidate for this joint characterization is the coupling between the structural and functional brain networks (SC-FC coupling). We therefore investigated the effect of Aβ accumulation on global SC-FC coupling in patients with mild cognitive impairment (MCI), AD, and healthy controls. Patients with MCI were dichotomized according to their level of Aβ pathology seen in 18F-flutemetamol PET-CT scans-namely, Aβ-negative and Aβ-positive. Our results show that there was no difference in global SC-FC coupling between different cohorts. During the prodromal AD stage, there was a significant negative correlation between the level of Aβ pathology and the global SC-FC coupling of MCI patients with positive Aβ, but no significant correlation for MCI patients with negative Aβ. During the AD dementia stage, the correlation between Aβ pathology and global SC-FC coupling in patients with AD was positive. Our results suggest that Aβ pathology has distinctive stage-specific effects on global coupling between the structural and functional brain networks along the AD continuum.
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Yeung MK, Lee TL, Chan AS. Depressive and anxiety symptoms are related to decreased lateral prefrontal cortex functioning during cognitive control in older people. Biol Psychol 2021; 166:108224. [PMID: 34785277 DOI: 10.1016/j.biopsycho.2021.108224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/26/2021] [Accepted: 11/07/2021] [Indexed: 11/18/2022]
Abstract
Some studies have found a relationship between negative emotional symptoms and decreased lateral PFC functioning during a cognitive control task in healthy younger adults. Here, we asked whether this relationship is also present in the general older population and across different functional domains of the lateral PFC. Thirty-six older people (13 males) self-reported their recent depressive and anxiety symptoms. They also took two cognitive control tasks known to differentially engage the lateral frontoparietal network (digit n-back task) and the lateral frontotemporal network (Category Fluency Test) while hemodynamic changes in the PFC were monitored by functional near-infrared spectroscopy (fNIRS). Both depressive and anxiety symptoms were associated with decreased activation in the bilateral lateral PFC during cognitive control performance. Interestingly, these relationships were driven by the n-back task. Our findings suggest that depressive and anxiety symptoms are related to decreased lateral PFC functioning in particular domains of cognitive control among older people.
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Affiliation(s)
- Michael K Yeung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Tsz L Lee
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes S Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China; Research Center for Neuropsychological Well-being, The Chinese University of Hong Kong, Hong Kong, China.
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