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Bugallo-Carrera C, Dosil-Díaz C, Pereiro AX, Anido-Rifón L, Gandoy-Crego M. Factors that indicate performance on the MoCA 7.3 in healthy adults over 50 years old. BMC Geriatr 2024; 24:482. [PMID: 38824525 PMCID: PMC11144337 DOI: 10.1186/s12877-024-05102-1] [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: 07/18/2023] [Accepted: 05/22/2024] [Indexed: 06/03/2024] Open
Abstract
Human aging is a physiological, progressive, heterogeneous global process that causes a decline of all body systems, functions, and organs. Throughout this process, cognitive function suffers an incremental decline with broad interindividual variability.The first objective of this study was to examine the differences in the performance on the MoCA test (v. 7.3) per gender and the relationship between the performance and the variables age, years of schooling, and depressive symptoms .The second objective was to identify factors that may influence the global performance on the MoCA test (v. 7.3) and of the domains orientation, language, memory, attention/calculation, visuospatial and executive function, abstraction, and identification.A cross-sectional study was carried out in which five hundred seventy-three (573) cognitively healthy adults ≥ 50 years old were included in the study. A sociodemographic questionnaire, the GDS-15 questionnaire to assess depression symptoms and the Spanish version of the MoCA Test (v 7.3) were administered. The evaluations were carried out between the months of January and June 2022. Differences in the MoCA test performance per gender was assessed with Student's t-test for independent samples. The bivariate Pearson correlation was applied to examine the relationship between total scoring of the MoCA test performance and the variables age, years of schooling, and depressive symptoms. Different linear multiple regression analyses were performed to determine variables that could influence the MoCA test performance.We found gender-related MoCA Test performance differences. An association between age, years of schooling, and severity of depressive symptoms was observed. Age, years of schooling, and severity of depressive symptoms influence the MoCA Test performance, while gender does not.
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Affiliation(s)
- César Bugallo-Carrera
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Dosil-Díaz
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Arturo X Pereiro
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Manuel Gandoy-Crego
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
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Sta. Maria MT, Hasegawa Y, Khaing AMM, Salazar S, Ono T. The relationships between mastication and cognitive function: A systematic review and meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:375-388. [PMID: 38022390 PMCID: PMC10630119 DOI: 10.1016/j.jdsr.2023.10.001] [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: 09/30/2022] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Abstract
Masticatory function such as chewing is expected to modify human cognitive function, and/or the possibility of improving cognitive function is also predicted. This systematic review investigated whether masticatory function affects cognitive function for older/young adults. Full articles written in English from January 2000 to April 2022 were collected using PubMed and Cochrane Library. Target outcomes were cognitive function test scores, cognitive processing speed (reaction time), and masticatory function. For each research question, two independent reviewers conducted the search and screening, data extraction, quality assessment, and risk of bias assessment. The reviewers resolved any disagreements by discussion. From 226 articles retrieved, 20 were included in this review. Older adults with lower scores on the cognitive function test had lower masticatory performance, lower chewing ability, chewing difficulty, and decreased number of teeth. An increased risk of cognitive impairment was found in older adults with masticatory dysfunction. For young adults, gum chewing significantly reduced the processing speed of cognitive tasks compared to no gum chewing. Although most of the evidence included had a low level of evidence and a high risk of bias because of the research designs, the results still suggest that mastication may be a factor in improving cognitive function.
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Affiliation(s)
- Ma. Therese Sta. Maria
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Prosthodontics, College of Dentistry, Manila Central University, Caloocan, Philippines
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Aye Mya Mya Khaing
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Simonne Salazar
- Department of Prosthodontics, Faculty of Dentistry, Centro Escolar University, Makati, Philippines
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
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Pietrzak B, Kujawa J, Lipert A. Depressive Disorders, Cognitive and Physical Function of Older People in Early Dementia Detection. Life (Basel) 2023; 13:2010. [PMID: 37895392 PMCID: PMC10608476 DOI: 10.3390/life13102010] [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: 09/04/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Aging is associated with cognitive decline, leading to cognitive and physical impairments, which are risk factors for loss of independence and dementia development. Early diagnosis is beneficial for both, the patient and their family, to avoid long-term consequences. The aim of this study was to analyze the frequency of depressive disorders and their influence on cognitive and physical function of older people in early dementia detection. METHODS There were 852 patients, aged at least 60 years, from the Central Teaching Hospital. The study was conducted between September 2022 and June 2023. The qualified participants were examined using four tools: Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Timed Up and Go (TUG) and Schulman's Clock-Drawing Test. RESULTS Over one-third had depressive disorders. A relationship with p < 0.05 was observed between GDS and IADL: r = -0.61. A relationship with p > 0.05 was observed between GDS and TUG: r = -024. A relationship with p < 0.05 was observed between GDS and CDT: r = 0.74. CONCLUSIONS The first signs of depressive disorders in older people may be considered an indication for further diagnosis of dementia.
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Affiliation(s)
- Beata Pietrzak
- Department of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (B.P.); (J.K.)
| | - Jolanta Kujawa
- Department of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (B.P.); (J.K.)
| | - Anna Lipert
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland
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Gender differences in the association of depression trajectories with executive and memory functions: Evidence from the longitudinal study of the Survey of Health, Ageing and Retirement in Europe (2004-2017). J Psychiatr Res 2022; 149:177-184. [PMID: 35278782 DOI: 10.1016/j.jpsychires.2022.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022]
Abstract
Gender differences in depression trajectories and their effects on cognitive function are poorly understood. This article aims to identify depression trajectories in both genders and further explore the association of depression trajectories with executive and memory functions by gender. A total 3990 participants aged 50 years or older with repeated measurements from waves 1 to 7 (wave 3 excluded) of the Study of the Survey of Health, Ageing and Retirement in Europe (SHARE) were included. Group-based trajectory modeling (GBTM) was conducted to identify the optimal number of depression trajectories. Generalized estimating equation (GEE) models were used to examine the relation of depression trajectories to cognitive function after stratification by gender. Three distinct depression trajectories were identified in both genders, but the patterns of trajectories among genders were nonidentical. The trajectories of depression in males were characterized by non-low, moderate, persistent-depressive symptoms but with an unstable trend, while in females, they were characterized by non-low, moderate, persistent-depressive symptoms and with a worsening trend. The prevalence of persistent high depression in women (20.08%) was higher than that in men (3.13%). Moderate and persistent high depression trajectories were negatively associated with episodic memory (β = -0.53 and -0.72, respectively, p < 0.001) and verbal fluency in females (β = -0.96 and -1.47, p=0.01 and < 0.001, respectively). Older women had a greater frequency of developing depression than older men. Gender differences in depression trajectories existed. Moderate and persistent high depression trajectories exerted a negative effect on some domains of cognitive impairment only in females.
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Park MS, Park YK, Kim E, Kim H. Development of visual-motor integration scale for the Korean old people. J Exerc Rehabil 2021; 17:279-286. [PMID: 34527640 PMCID: PMC8413909 DOI: 10.12965/jer.2142338.169] [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: 06/01/2021] [Accepted: 06/29/2021] [Indexed: 11/22/2022] Open
Abstract
Effective methods to detect old people cognitive decline in early stages are needed in Korea, which is the fastest aging country in the world. This study aimed to develop a brief cognitive function measurement, Visual-Motor Integration Scale for the Korean elderly (VMIS-KE). In this methodological research, 16 preliminary items on visual-motor integration for the old people were chosen after literature review and expert validation. One hundred eighty participants aged 20–79 years were recruited to verify the validity and reliability of this measurement from community sources in Daegu city. The collected data were analyzed by exploratory factor analysis and confirmative factor analysis using SPSS and AMOS 18.0 program. The three factors (figure cognition, memory, and spatial cognition) with 12 items were finally extracted. Goodness of the fit was confirmed through confirmatory factor analysis. The Cronbach α was 0.867. The scores of overall VMIS-KE and every subcategory significantly decreased with age, especially in the 70s. VMIS-KE is the first valid and reliable measurement to assess cognitive decline of the Korean old people through visual motor integration, and can easily and quickly detect high-risk groups of dementia regardless of their educational level.
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Affiliation(s)
- Mi-Sook Park
- Department of Health and Welfare for Elderly, Daegu Haany University, Gyeongsan, Korea
| | | | - Eunhwi Kim
- Department of Nursing, Kyungil University, Gyeongsan, Korea
| | - Hong Kim
- Department of Korean Sports Medicine, Daegu Haany University, Gyeongsan, Korea
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Cho MJ, Shin HE, Amano A, Song KB, Choi YH. Effect of Molar Occlusal Balance on Cognitive Function in the Elderly. Int Dent J 2021; 72:331-337. [PMID: 34376281 PMCID: PMC9275330 DOI: 10.1016/j.identj.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/04/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Elderly people with dementia, who are increasing at a rate comparable to the rate at which theelderly population is growing, are becoming a serious social problem in Korea. Therefore, the purpose of this study was to investigate the association between molar occlusal balance and cognitive function among Koreans aged 65 years and older. METHODS A total of 308 participants aged 65 years and older who attended a senior center were recruited for the study with their consent. The Korean version of the Mini-Mental State Examination (MMSE-DS) was used to assess cognitive function, and masticatory ability was measured according to the ability to chew food, the number of remaining teeth, and the self-perceived perceived masticatory function. Relative molar occlusal balance was measured using the T-scan Ⅲ system. All collected data were analysed using SPSS version 23.0. RESULTS There was a significant association between cognitive function and molar masticatory ability (P < .05). The participants with relative molar occlusal balance had a higher MMSE-DS score when compared to those with relative incision occlusal balance, adjusted for sociodemographic factors and number of remaining teeth, subjective masticatory ability, chewing ability, occlusion time, and denture use. Cognitive function was higher when relative molar occlusion was greater compared to anterior occlusion in anterior-posterior teeth balance. CONCLUSIONS Cognitive function in elderly people was higher when the relative molar occlusal balance was greater. Mastication with posterior teeth may have a more important effect on stimulation of cognitive function. Therefore, oral health care focusing on maintenance of molar teeth may be crucial for elderly persons.
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Affiliation(s)
- Min-Jeong Cho
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea; Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea
| | - Hae-Eun Shin
- Division of Health and Nutrition Survey, Korea Centers for Disease Control & Prevention, Cheongju, Korea
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Keun-Bae Song
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea; Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Korea.
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Park T, Jung YS, Son K, Bae YC, Song KB, Amano A, Choi YH. More Teeth and Posterior Balanced Occlusion Are a Key Determinant for Cognitive Function in the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041996. [PMID: 33669490 PMCID: PMC7922962 DOI: 10.3390/ijerph18041996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/13/2021] [Accepted: 02/14/2021] [Indexed: 11/16/2022]
Abstract
Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability and cognitive function in the elderly. A total of 563 participants aged 65 years or over residing in urban and rural areas of South Korea were surveyed. The chewing ability was measured by objectively measurable indications such as the number of remaining teeth, denture status, color-changeable gum, and occlusal balance using T-Scan III®. The cognitive function was measured by the Korean version of Mini-Mental State Examination-Dementia Screening (MMSE-DS) and a score of 24 or more (out of 30) indicates a normal cognition, below 23 indicates cognitive impairment. The association between socio-demographic factors, chewing ability factors, and cognitive function demonstrated statistically significant results. When comparing the denture status and chewing ability, the proportion of need denture group had fewer remaining teeth and anterior balanced occlusion. The average number of remaining teeth in anterior balanced occlusion with cognitive impairment was 11.2 compared to posterior balanced occlusion with the normal cognition 19.2. A multiple linear regression analysis declared a significant correlation between number of remaining teeth, denture status, occlusal balance, and cognitive function. Results of the present study revealed objectively measurable indications are suitable for chewing ability assessment and correlated with cognitive function.
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Affiliation(s)
- Taejun Park
- Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu 41940, Korea; (T.P.); (K.-B.S.)
| | - Yun-Sook Jung
- Department of Dental Hygiene, Kyungpook National University College of Science & Technology, Sangju 37224, Korea;
| | - Keunbada Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu 41940, Korea;
| | - Yong-Chul Bae
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea;
| | - Keun-Bae Song
- Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu 41940, Korea; (T.P.); (K.-B.S.)
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan;
| | - Youn-Hee Choi
- Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu 41940, Korea; (T.P.); (K.-B.S.)
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu 41940, Korea
- Correspondence:
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Chan YLE, Chen MH, Tsai SJ, Bai YM, Tsai CF, Cheng CM, Su TP, Chang WH, Chen TJ, Li CT. Treatment-Resistant depression enhances risks of dementia and alzheimer's disease: A nationwide longitudinal study. J Affect Disord 2020; 274:806-812. [PMID: 32664018 DOI: 10.1016/j.jad.2020.05.150] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/17/2020] [Accepted: 05/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous evidence indicates late-onset depression or depression with greater severity are associated with subsequent risk of dementia or Alzheimer's disease (AD). However, whether treatment-resistant depression is associated with such risks remain elusive. METHODS Using the Taiwan Nationwide Health Insurance Research Database, 3,345 patients with newly-diagnosed major depressive disorder (MDD) and 13,380 well-matched controls were enrolled between 2002 and 2004. MDD patients were stratified according to their treatment response to adequate antidepressant trials, and all participants were followed up until the end of 2013. Those who developed dementia and AD were identified. RESULTS MDD patients were more likely to develop dementia and AD than controls. Difficult-to-treat patients (i.e., DTT; those who failed to respond to at least two adequate antidepressant trials) had the highest risk of developing dementia (hazard ratio [HR] = 5.19) and AD (HR 4.44), whereas easy-to-treat patients (i.e., ETT-1; those who had no prescription of antidepressants) had the lowest risk of developing dementia (HR 2.37) and AD (HR 2.59) compared with controls. Subsequent analysis demonstrated that only among patients with late-onset depression (age > 65 years), DTT patients consistently showed higher risks and faster development of dementia (HR 6.64, mean: 1.45 yr) and AD (HR 4.97, mean: 1.67 yr) than did ETT-1 patients and controls. LIMITATIONS Subjects who have not received medical examination were not included as diagnosis were determined by ICD codes. Also, longer follow-up period might be needed for the younger group. CONCLUSIONS Late-onset treatment-resistant depression is associated with an elevated risk of dementia and AD.
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Affiliation(s)
- Yee-Lam E Chan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science and Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science and Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Cognitive Neuroscience, National Central University, Jhongli, Taiwan.
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Aichele S, Ghisletta P. Memory Deficits Precede Increases in Depressive Symptoms in Later Adulthood. J Gerontol B Psychol Sci Soc Sci 2020; 74:943-953. [PMID: 29385518 DOI: 10.1093/geronb/gbx183] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 12/29/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We examined bidirectional, time-ordered associations between age-related changes in depressive symptoms and memory. METHOD Data came from 107,599 community-dwelling adults, aged 49-90 years, who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Depressive symptoms were measured with the EURO-D inventory, and memory was evaluated as delayed recall of a 10-word list. Participants were assessed up to five times at 2-year intervals. Dynamic structural equation models were used to estimate longitudinal and time-ordered (lead-lag) relations between depressive symptoms and memory performance. RESULTS Depressive symptoms increased and memory scores decreased across the observed age range, with worsening mostly evident after age 62 years. These long-term changes were moderately negatively correlated (r = -.53, p < .001). A time-ordered effect emerged such that age-specific memory deficits preceded shorter-term increases in depression symptoms. This effect can be translated such that each 1-point decrement on a 10-point memory scale at a given age predicted a 14.5% increased risk for depression two years later. Statistical adjustment for covariates (sex, education, re-test, smoking, and body mass index) had little influence on these associations. CONCLUSION In later adulthood, lower memory performance at a given age predicts subsequent 2-year increases in depressive symptoms.
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Affiliation(s)
- Stephen Aichele
- Swiss National Center of Competence in Research LIVES-Overcoming vulnerability: Life course perspectives, Universities of Lausanne and of Geneva, Switzerland
| | - Paolo Ghisletta
- Swiss National Center of Competence in Research LIVES-Overcoming vulnerability: Life course perspectives, Universities of Lausanne and of Geneva, Switzerland.,Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss Distance Learning University, Switzerland
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Shin H, Cho M, Amano A, Song K, Choi Y. Association between mastication‐related factors and the prevalence of dementia in Korean elderly women visiting senior centres. Gerodontology 2019; 37:177-184. [DOI: 10.1111/ger.12453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 10/23/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Hae‐Eun Shin
- Department of Preventive Dentistry School of Dentistry Kyungpook National University Daegu Korea
| | - Min‐Jeong Cho
- Department of Preventive Dentistry School of Dentistry Kyungpook National University Daegu Korea
- Department of Dental Hygiene College of Science & Technology Kyungpook National University Sangju Korea
| | - Atsuo Amano
- Department of Preventive Dentistry Osaka University Graduate School of Dentistry Osaka Japan
| | - Keun‐Bae Song
- Department of Preventive Dentistry School of Dentistry Kyungpook National University Daegu Korea
| | - Youn‐Hee Choi
- Department of Preventive Dentistry School of Dentistry Kyungpook National University Daegu Korea
- Institute for Translational Research in Dentistry Kyungpook National University Daegu Korea
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Associations Among Health Insurance Type, Cardiovascular Risk Factors, and the Risk of Dementia: A Prospective Cohort Study in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142616. [PMID: 31340465 PMCID: PMC6679085 DOI: 10.3390/ijerph16142616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 11/30/2022]
Abstract
Due to an aging population, dementia incidence has rapidly increased in South Korea, heaping psychological and economic burdens upon families and the society. This study was aimed at investigating the associations of health insurance type and cardiovascular risk factors with the risk of dementia. The study was performed using data from 15,043 participants aged 60 years and above, enrolled in the Seoul Dementia Management Project in 2008 and followed up until 2012. Factors such as demographic data, health insurance type, lifestyle factors, and cardiovascular risk factors were subjected to Cox proportional hazard regression analysis to identify their associations with dementia incidence. During the follow-up, 495 participants (3.3%) developed dementia. Medical Aid beneficiaries were associated with an increase in the risk of dementia (hazard ratio [HR] 1.77, 95% confidence interval [CI] 1.421–2.215). Upon analyzing a composite cardiovascular risk score derived from all five cardiovascular risk factors, the risk for dementia incidence in participants increased from 1.56 for the presence of three risk factors to 2.55 for that of four risk factors (HR 2.55, 95% CI 1.174–5.546), compared with those who had no risk factors. The Medical Aid beneficiaries of health insurance type and the presence of multiple cardiovascular risk factors were found to be associated with a higher risk of dementia incidence.
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Shin HE, Cho MJ, Choi YH, Song KB. Evaluation of relationship between cognitive function and occlusal status in elderly individuals using the T-scan III® system. ACTA ACUST UNITED AC 2017. [DOI: 10.11149/jkaoh.2017.41.2.96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hae-Eun Shin
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Min-Jeong Cho
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Keun-Bae Song
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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Creavin ST, Wisniewski S, Noel‐Storr AH, Trevelyan CM, Hampton T, Rayment D, Thom VM, Nash KJE, Elhamoui H, Milligan R, Patel AS, Tsivos DV, Wing T, Phillips E, Kellman SM, Shackleton HL, Singleton GF, Neale BE, Watton ME, Cullum S. Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations. Cochrane Database Syst Rev 2016; 2016:CD011145. [PMID: 26760674 PMCID: PMC8812342 DOI: 10.1002/14651858.cd011145.pub2] [Citation(s) in RCA: 311] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The Mini Mental State Examination (MMSE) is a cognitive test that is commonly used as part of the evaluation for possible dementia. OBJECTIVES To determine the diagnostic accuracy of the Mini-Mental State Examination (MMSE) at various cut points for dementia in people aged 65 years and over in community and primary care settings who had not undergone prior testing for dementia. SEARCH METHODS We searched the specialised register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), LILACS (BIREME), ALOIS, BIOSIS previews (Thomson Reuters Web of Science), and Web of Science Core Collection, including the Science Citation Index and the Conference Proceedings Citation Index (Thomson Reuters Web of Science). We also searched specialised sources of diagnostic test accuracy studies and reviews: MEDION (Universities of Maastricht and Leuven, www.mediondatabase.nl), DARE (Database of Abstracts of Reviews of Effects, via the Cochrane Library), HTA Database (Health Technology Assessment Database, via the Cochrane Library), and ARIF (University of Birmingham, UK, www.arif.bham.ac.uk). We attempted to locate possibly relevant but unpublished data by contacting researchers in this field. We first performed the searches in November 2012 and then fully updated them in May 2014. We did not apply any language or date restrictions to the electronic searches, and we did not use any methodological filters as a method to restrict the search overall. SELECTION CRITERIA We included studies that compared the 11-item (maximum score 30) MMSE test (at any cut point) in people who had not undergone prior testing versus a commonly accepted clinical reference standard for all-cause dementia and subtypes (Alzheimer disease dementia, Lewy body dementia, vascular dementia, frontotemporal dementia). Clinical diagnosis included all-cause (unspecified) dementia, as defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM); International Classification of Diseases (ICD) and the Clinical Dementia Rating. DATA COLLECTION AND ANALYSIS At least three authors screened all citations.Two authors handled data extraction and quality assessment. We performed meta-analysis using the hierarchical summary receiver-operator curves (HSROC) method and the bivariate method. MAIN RESULTS We retrieved 24,310 citations after removal of duplicates. We reviewed the full text of 317 full-text articles and finally included 70 records, referring to 48 studies, in our synthesis. We were able to perform meta-analysis on 28 studies in the community setting (44 articles) and on 6 studies in primary care (8 articles), but we could not extract usable 2 x 2 data for the remaining 14 community studies, which we did not include in the meta-analysis. All of the studies in the community were in asymptomatic people, whereas two of the six studies in primary care were conducted in people who had symptoms of possible dementia. We judged two studies to be at high risk of bias in the patient selection domain, three studies to be at high risk of bias in the index test domain and nine studies to be at high risk of bias regarding flow and timing. We assessed most studies as being applicable to the review question though we had concerns about selection of participants in six studies and target condition in one study.The accuracy of the MMSE for diagnosing dementia was reported at 18 cut points in the community (MMSE score 10, 14-30 inclusive) and 10 cut points in primary care (MMSE score 17-26 inclusive). The total number of participants in studies included in the meta-analyses ranged from 37 to 2727, median 314 (interquartile range (IQR) 160 to 647). In the community, the pooled accuracy at a cut point of 24 (15 studies) was sensitivity 0.85 (95% confidence interval (CI) 0.74 to 0.92), specificity 0.90 (95% CI 0.82 to 0.95); at a cut point of 25 (10 studies), sensitivity 0.87 (95% CI 0.78 to 0.93), specificity 0.82 (95% CI 0.65 to 0.92); and in seven studies that adjusted accuracy estimates for level of education, sensitivity 0.97 (95% CI 0.83 to 1.00), specificity 0.70 (95% CI 0.50 to 0.85). There was insufficient data to evaluate the accuracy of the MMSE for diagnosing dementia subtypes.We could not estimate summary diagnostic accuracy in primary care due to insufficient data. AUTHORS' CONCLUSIONS The MMSE contributes to a diagnosis of dementia in low prevalence settings, but should not be used in isolation to confirm or exclude disease. We recommend that future work evaluates the diagnostic accuracy of tests in the context of the diagnostic pathway experienced by the patient and that investigators report how undergoing the MMSE changes patient-relevant outcomes.
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Affiliation(s)
- Sam T Creavin
- University of BristolSchool of Social and Community MedicineCarynge Hall39 Whatley RoadBristolUKBS8 2PS
| | - Susanna Wisniewski
- Cochrane Dementia and Cognitive Improvement Group, Oxford UniversityOxfordUK
| | - Anna H Noel‐Storr
- University of OxfordRadcliffe Department of MedicineRoom 4401c (4th Floor)John Radcliffe Hospital, HeadingtonOxfordUKOX3 9DU
| | - Clare M Trevelyan
- Avon and Wiltshire Mental Health Partnership NHS TrustMedical EducationWoodland View, Brentry LaneBristolUKBS10 6NB
| | - Thomas Hampton
- Frimley Health NHS Foundation TrustENTFrimley Park HospitalPortsmouth RoadFrimley, CamberleySurreyUKGU16 7UJ
| | - Dane Rayment
- Avon and Wiltshire Partnership NHS TrustOlder Adult PsychiatryJenner House, Langley ParkChippenhamWiltshireUKSN15 1GG
| | - Victoria M Thom
- Avon & Wiltshire Mental Health Partnership NHS TrustForensic PsychiatryFromeside, Blackberry Hill HospitalBristolUKBS16 1EG
| | | | - Hosam Elhamoui
- Somerset Partnership NHS TrustPsychiatry91 Comeytrowe LaneTauntonSomersetUKTA1 5QG
| | - Rowena Milligan
- Mansion House SurgeryGeneral PracticeAbbey StreetStoneStaffordshireUKST15 0WA
| | - Anish S Patel
- Avon and Wiltshire Mental Health Partnership NHS TrustNBT Acute Mental Health Liaison TeamDonal Early HouseSouthmead HospitalBristolUKBS10 5NB
| | - Demitra V Tsivos
- North Bristol NHS TrustNeuropsychologySouthmead HospitalBristolUKBS10 5NB
| | - Tracey Wing
- Taunton and Somerset NHS trustCare of Elderly/ITU/A+EBristolUKBS1 3DH
| | - Emma Phillips
- 2gether NHS Foundation TrustCharlton Lane HospitalCheltenhamGloucestershireUKGL53 9DZ
| | - Sophie M Kellman
- Avon and Wiltshire Mental Health Partnership NHS TrustJenner House, Langley ParkChippenhamWiltshireUKSN15 1GG
| | - Hannah L Shackleton
- NHS ScotlandNHS Forth ValleyFalkirk Community Hospital, Majors LoanFalkirkUK
| | | | - Bethany E Neale
- RCGP Severn FacultyGeneral PracticeDeanery HouseBristolUKBA16 1GW
| | | | - Sarah Cullum
- University of BristolSchool of Social and Community MedicineCarynge Hall39 Whatley RoadBristolUKBS8 2PS
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Pai MC, Aref H, Bassil N, Kandiah N, Lee JH, Srinivasan AV, diTommaso S, Yuksel O. Real-world evaluation of compliance and preference in Alzheimer's disease treatment. Clin Interv Aging 2015; 10:1779-87. [PMID: 26622172 PMCID: PMC4639476 DOI: 10.2147/cia.s85319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Rivastigmine transdermal patch has shown higher caregiver satisfaction and greater preference than oral formulation in patients with Alzheimer’s disease. However, there is limited literature available related to caregiver preference or treatment compliance in real-world clinical settings. To date, no such data are available from Asia and the Middle East, which account for a sizeable proportion of patients with Alzheimer’s disease. The objective of this study was to evaluate treatment preference and compliance with oral and transdermal medications in daily clinical practice in an ethnically diverse patient population from Asia and the Middle East with mild-to-moderate Alzheimer’s disease. Patients and methods RECAP (Real-world Evaluation of Compliance And Preference in the treatment of Alzheimer’s disease) was a 24-week, multicenter, prospective, noninterventional study. Two treatment cohorts were observed during the study: oral (cholinesterase inhibitors or memantine) and transdermal (rivastigmine patch). Caregiver preference, physician preference, and patient compliance were evaluated at week 24. Results A total of 978 of 1,931 enrolled patients (mean age: 72.8 years; 50.5% female) were in the transdermal cohort. For patients with exposure to both oral and transdermal monotherapy (n=330), a significant caregivers’ preference for the transdermal monotherapy was observed (82.7%; P<0.0001). Of the 89 participating physicians, 71 indicated preference for transdermal monotherapy. Patient compliance was also significantly higher for transdermal than oral monotherapy (P<0.0001). Conclusion Our study showed higher caregiver and physician preference and greater patient compliance with transdermal monotherapy in daily practice.
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Affiliation(s)
- Ming-Chyi Pai
- Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan ; Alzheimer's Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Hany Aref
- Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Nazem Bassil
- Saint Georges Hospital Medical Center, Balamand University, Beirut, Lebanon
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea
| | - A V Srinivasan
- The Tamil Nadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | | | - Ozgur Yuksel
- Novartis Pharma AG, Postfach, Basel, Switzerland
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Li CL, Hsu HC. Cognitive function and associated factors among older people in Taiwan: age and sex differences. Arch Gerontol Geriatr 2014; 60:196-200. [PMID: 25456889 DOI: 10.1016/j.archger.2014.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 10/06/2014] [Accepted: 10/07/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to examine cognitive function and the risk and the protective factors by age and sex among Taiwanese older people. METHODS The data were from a nation-representative panel of older people in Taiwan. The participants completing both the 2003 and 2007 waves were included for analysis in this study (n=3228). Descriptive analysis and generalized linear model were applied, and the samples were stratified by age groups and by sex. RESULTS The factors related to higher cognitive function at the intercept included being younger, male, higher education, and doing unpaid work. At the time slope, the age effect and physical function difficulties would reduce the cognitive function across time, while education and providing informational support would increase the cognitive function across time. There were age- and sex-differences in the factors related to cognitive function, particularly on the working status and social participation. CONCLUSION Different health promotion strategies to target these populations should be accordingly developed.
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Affiliation(s)
- Cheng-Lun Li
- Department of Health Care Administration, Research Center on Health Policy and Management, Asia University, No. 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan
| | - Hui-Chuan Hsu
- Department of Health Care Administration, Research Center on Health Policy and Management, Asia University, No. 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University.
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Increased risk of dementia among chronic osteomyelitis patients. Eur J Clin Microbiol Infect Dis 2014; 34:153-159. [DOI: 10.1007/s10096-014-2200-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/27/2014] [Indexed: 10/24/2022]
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Bennett S, Thomas AJ. Depression and dementia: cause, consequence or coincidence? Maturitas 2014; 79:184-90. [PMID: 24931304 DOI: 10.1016/j.maturitas.2014.05.009] [Citation(s) in RCA: 313] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/16/2014] [Accepted: 05/17/2014] [Indexed: 10/25/2022]
Abstract
The relationship between depression and dementia is complex and still not well understood. A number of different views exist regarding how the two conditions are linked as well as the underlying neurobiological mechanisms at work. This narrative review examined longitudinal and cross sectional studies in the existing literature and determined the evidence supporting depression being a risk factor, a prodrome, a consequence, or an independent comorbidity in dementia. Overall there is convincing evidence to support both the notion that early life depression can act as a risk factor for later life dementia, and that later life depression can be seen as a prodrome to dementia. There is also evidence to support both conditions showing similar neurobiological changes, particularly white matter disease, either indicating shared risk factors or a shared pattern of neuronal damage. These findings highlight the need to examine if effective treatment of depressive episodes has any effect in reducing the prevalence of dementia, as well as clinicians being vigilant for late life depression indicating the incipient development of dementia, and therefore carefully following up these individuals for future cognitive impairment.
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Affiliation(s)
- Sophia Bennett
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom
| | - Alan J Thomas
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
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Chuang CS, Lin CL, Lin MC, Sung FC, Kao CH. Decreased prevalence of dementia associated with statins: a national population-based study. Eur J Neurol 2014; 22:912-8. [PMID: 24635778 DOI: 10.1111/ene.12402] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 02/07/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Dementia is a neurodegenerative disorder that presents a progressive decline in cognitive function and loss of short-term memory with age. Several studies have shown that statin, an oral lipid-lowering drug, may reduce the risk of developing dementia. The objective of this study is to explore the association between statin and the development of dementia. METHODS The data analyzed in this study were retrieved from the National Health Insurance Research Database in Taiwan. The sample consisted of 123 300 patients ≥ 20 years of age, including 61 650 dementia patients with statin use and 61 650 patients without statin use who were eligible for inclusion in this study. Univariate and multivariate Cox proportional hazard regression analyses were performed to measure the effects of statin use on the risk of dementia. RESULTS The beneficial effect of statin on dementia was significant after adjusting for sociodemographic factors and comorbidities (adjusted hazard ratio of 0.92, 95% confidence interval 0.86-0.98). The sex- and age-specific analysis of adjusted hazard ratios showed a higher beneficial effect from statin treatment in women than in men, and the effect became more significant with age. CONCLUSION Statin therapy may help prevent the development of dementia, and both hydrophilic and lipophilic statins produce similar effects. However, the preventive characters and associated mechanisms must be further explored and identified.
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Affiliation(s)
- C-S Chuang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan
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Su X, Shang L, Xu Q, Li N, Chen J, Zhang L, Zhang L, Hua Q. Prevalence and predictors of mild cognitive impairment in Xi'an: a community-based study among the elders. PLoS One 2014; 9:e83217. [PMID: 24421876 PMCID: PMC3885430 DOI: 10.1371/journal.pone.0083217] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 10/31/2013] [Indexed: 11/18/2022] Open
Abstract
Mild cognitive impairment (MCI) is an intermediate stage between normal cognitive function and dementia among aging individuals. This study was designed to estimate the prevalence of MCI and explore the possible risk factors including gender disparities among community-dwelling older individuals. The study was conducted in Xi'an, China. This is a cross-sectional study. A total of 815 individuals, 60 years and older were selected by stratified random cluster sampling. Cognitive function was measured using the mini-mental status examination (MMSE), the Chinese version of the Dementia Rating Scales (CDRS) was used to apply the diagnostic of non-dementia, and activities of daily living (ADL) and instrumental activities of daily living (IADL) systems were used to functional status. The association between sociodemographic characteristics, lifestyle, history of chronic diseases and MCI were evaluated separately for men and women using the Pearson χ²-test and binary logistic regression. Of the 815 community-dwelling individuals, 145 were found to have MCI. Overall, the prevalence of MCI was 18.5%, with a prevalence of 19.6% in women (105/535), and 15.3% (40/261) in men. The results of the binary logistical regression analysis indicated that age and history of stroke were associated with MCI in men. For women, the risk factors were lower level of educational and lack of religious attendance. Results suggested that the factors capable of influencing MCI differed profoundly between older men and older women. For this reason, different preventative measures should be adopted to delay or reverse cognitive impairment among community-dwelling older men and women.
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Affiliation(s)
- Xiangni Su
- Department of Nursing, the Fourth Military Medical University, Xi’an, China
| | - Lei Shang
- Department of Health Statistics, the Fourth Military Medical University, Xi’an, China
| | - Qiaoling Xu
- Department of Nursing, the Fourth Military Medical University, Xi’an, China
| | - Nannan Li
- Department of Nursing, the Fourth Military Medical University, Xi’an, China
| | - Jianhua Chen
- Department of Nursing, the Fourth Military Medical University, Xi’an, China
| | - Liping Zhang
- Department of Nursing, the Health College, Xi’an, China
| | - Lei Zhang
- Department of Epidemiology, the Fourth Military Medical University, Xi’an, China
| | - Qianzhen Hua
- Department of Nursing, the Fourth Military Medical University, Xi’an, China
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Tola-Arribas MA, Yugueros MI, Garea MJ, Ortega-Valín F, Cerón-Fernández A, Fernández-Malvido B, San José-Gallegos A, González-Touya M, Botrán-Velicia A, Iglesias-Rodríguez V, Díaz-Gómez B. Prevalence of dementia and subtypes in Valladolid, northwestern Spain: the DEMINVALL study. PLoS One 2013; 8:e77688. [PMID: 24147055 PMCID: PMC3798383 DOI: 10.1371/journal.pone.0077688] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/03/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To describe the prevalence of dementia and subtypes in a general elderly population in northwestern Spain and to analyze the influence of socio-demographic factors. METHODS Cross-sectional, two-phase, door-to-door, population-based study. A total of 870 individuals from a rural region and 2,119 individuals from an urban region of Valladolid, Spain, were involved. The seven-minute screen neurocognitive battery was used in the screening phase. A control group was included. RESULTS A total of 2,170 individuals aged 65 to 104 years (57% women) were assessed. There were 184 subjects diagnosed with dementia. The crude prevalence was 8.5% (95% CI: 7.3-9.7). Age- and sex-adjusted prevalence was 5.5 (95% CI: 4.5-6.5). Main subtypes of dementia were: Alzheimer's disease (AD) 77.7%, Lewy Body disease, 7.6% and vascular dementia (VD) 5.9%. Crude prevalences were 6.6% (AD), 0.6% (Lewy Body disease), and 0.5% (VD). Dementia was associated with age (OR 1.14 for 1-year increase in age), female sex (OR 1.79) and the absence of formal education (OR 2.53 compared to subjects with primary education or more). CONCLUSION The prevalence of dementia in the study population was lower than the most recent estimates for Western Europe. There was a high proportion of AD among all dementia cases and very low prevalence of VD. Old age, female sex, and low education level were independent risk factors for dementia and AD.
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Affiliation(s)
| | | | - María José Garea
- Department of Neurology, Hospital Universitario Río Hortega, Valladolid, Spain
| | | | - Ana Cerón-Fernández
- Department of Geriatrics, Hospital Universitario Río Hortega, Valladolid, Spain
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Vilalta-Franch J, López-Pousa S, Llinàs-Reglà J, Calvó-Perxas L, Merino-Aguado J, Garre-Olmo J. Depression subtypes and 5-year risk of dementia and Alzheimer disease in patients aged 70 years. Int J Geriatr Psychiatry 2013; 28:341-50. [PMID: 22588687 DOI: 10.1002/gps.3826] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 04/11/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to estimate several subtypes of depressive disorders as risk factors for dementia and Alzheimer disease (AD) specifically. METHODS This is a population-based cohort study using a sample of 451 non-demented older people. Adjusted Cox proportional hazard models were calculated to determine the association of depression with dementia or AD development after 5 years. Baseline evaluation included the Cambridge Mental Disorders of the Elderly Examination (CAMDEX). Depressive disorders (major episode [MD] and minor depressive disorders [MDDIS]) were assessed following DSM-IV criteria and further classified according to the age at onset (early versus late onset). In turn, all late-onset depressions were grouped as with or without depression-executive dysfunction syndrome (DEDS). Dementia (and dementia subtypes) diagnoses were made using the CAMDEX. When the patients were deceased, the Retrospective Collateral Dementia Interview was used. RESULTS Late-onset depressions (both MD and MDDIS) were associated with increased dementia (hazard ratio [HR] = 2.635; 95% CI = 1.153-6.023; and HR = 2.517; 95% CI = 1.200-5.280, respectively), and AD (HR = 6.262; 95% CI = 2.017-19.446; and HR = 4.208; 95% CI = 1.828-9.685, respectively) after adjustment by age, gender, marital status, education, cognitive impairment, executive function and stroke history. A second model revealed that only late-onset depressions with DEDS increased the risk for both dementia (late-onset MD with DEDS: HR = 6.262; 95% CI = 2.017-19.446; late-onset MDDIS with DEDS: HR = 4.208; 95% CI = 1.828-9.685) and AD (late-onset MD with DEDS: HR = 7.807; 95% CI = 1.567-38.894; late-onset MDDIS with DEDS: HR = 6.099; 95% CI = 2.123-17.524). CONCLUSIONS Late-onset depressive episodes with DEDS are risk factors for dementia and AD development, regardless of the severity of the depression.
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Burton C, Campbell P, Jordan K, Strauss V, Mallen C. The association of anxiety and depression with future dementia diagnosis: a case-control study in primary care. Fam Pract 2013; 30:25-30. [PMID: 22915794 PMCID: PMC3552314 DOI: 10.1093/fampra/cms044] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Depression is identified as a risk factor for dementia. Little research has been carried out on the importance of anxiety, despite strong evidence of co-morbidity with depression. OBJECTIVE To examine the association of anxiety and depression with future dementia diagnosis. METHODS This case-control study was set in the Consultations in Primary Care Archive. Cases (n = 400), were patients aged >65 years old. About 1353 controls were matched to cases by gender, practice, age group and year of case diagnosis. Read codes of risk factors for dementia were searched in patient records. The associations of prior consultations for anxiety and depression, with future diagnosis of dementia were determined using multivariable logistic regression. RESULTS A past anxiety diagnosis was associated with a future dementia diagnosis [odds ratio 2.76 (95% confidence interval 2.11-3.62)]. The association of depression with dementia was attenuated by the high prevalence of anxiety within those who have depression. Including an interaction of depression and anxiety showed that having only depression was associated with future dementia diagnosis but a diagnosis of depression alongside anxiety did not increase the likelihood of a dementia diagnosis compared to having just an anxiety diagnosis. CONCLUSION Prior diagnosis of anxiety was strongly associated with dementia diagnosis after adjustment for other risk factors. The independent effect of depression was weaker compared to anxiety. Given the higher prevalence of anxiety primary care physicians should consider anxiety as well as depression as premorbid risk factors of dementia to improve early recognition and facilitate greater access to services.
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Affiliation(s)
- Claire Burton
- Arthritis Research UK Primary Care Centre, Keele University Keele, Staffordshire ST5 5BG, UK.
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Li L, Zhang W, Cheng S, Cao D, Parent M. Isoprenoids and related pharmacological interventions: potential application in Alzheimer's disease. Mol Neurobiol 2012; 46:64-77. [PMID: 22418893 DOI: 10.1007/s12035-012-8253-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 02/28/2012] [Indexed: 12/18/2022]
Abstract
Two major isoprenoids, farnesyl pyrophosphate and geranylgeranyl pyrophosphate, serve as lipid donors for the posttranslational modification (known as prenylation) of proteins that possess a characteristic C-terminal motif. The prenylation reaction is catalyzed by prenyltransferases. The lipid prenyl group facilitates to anchor the proteins in cell membranes and mediates protein-protein interactions. A variety of important intracellular proteins undergo prenylation, including almost all members of small GTPase superfamilies as well as heterotrimeric G protein subunits and nuclear lamins. These prenylated proteins are involved in regulating a wide range of cellular processes and functions, such as cell growth, differentiation, cytoskeletal organization, and vesicle trafficking. Prenylated proteins are also implicated in the pathogenesis of different types of diseases. Consequently, isoprenoids and/or prenyltransferases have emerged as attractive therapeutic targets for combating various disorders. This review attempts to summarize the pharmacological agents currently available or under development that control isoprenoid availability and/or the process of prenylation, mainly focusing on statins, bisphosphonates, and prenyltransferase inhibitors. Whereas statins and bisphosphonates deplete the production of isoprenoids by inhibiting the activity of upstream enzymes, prenyltransferase inhibitors directly block the prenylation of proteins. As the importance of isoprenoids and prenylated proteins in health and disease continues to emerge, the therapeutic potential of these pharmacological agents has expanded across multiple disciplines. This review mainly discusses their potential application in Alzheimer's disease.
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Affiliation(s)
- Ling Li
- Department of Experimental and Clinical Pharmacology, University of Minnesota, 2001 6th St SE, MTRF 4-208, Minneapolis, MN 55455, USA.
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Lai SW, Lin CH, Liao KF, Su LT, Sung FC, Lin CC. Association between polypharmacy and dementia in older people: a population-based case-control study in Taiwan. Geriatr Gerontol Int 2012; 12:491-8. [PMID: 22233227 DOI: 10.1111/j.1447-0594.2011.00800.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of the present study was to investigate whether polypharmacy correlates with the risk of dementia in older people. METHODS From representative claims data established from the National Health Insurance with a population coverage rate of 99% in Taiwan, we identified 7135 newly diagnosed patients with dementia in 2000-2008 and 2,8540 randomly selected controls without dementia, both aged ≥ 65 years. The daily use of prescribed drugs in the past 2 years was compared between cases and controls, controlling for demographic characters and comorbidities. RESULTS The incidence of dementia increased with the number of medications used and age. Cases were older than controls, predominant with women and more likely to use five or more drugs daily (44.0% vs 32.0%, P < 0.0001). Multivariate logistic regression analysis showed that, compared with participants using zero to one drug, the odds ratios (OR) of dementia were 1.28 (95% confidence interval [CI] 1.18-1.38) for those using two to four drugs, 1.34 (95% CI 1.23-1.46) for those using five to nine drugs and 1.56 (95% CI 1.38-1.76) for those using 10 or more drugs. Cerebrovascular disease (OR 3.19), diabetes mellitus (OR 1.23), chronic kidney disease (OR 1.21) and hypertension (OR 1.08) were significant comorbidities predicting the risk of dementia. There was significant interaction between cerebrovascular disease and the number of medications used in the dementia risk. CONCLUSIONS The risk of dementia increases steadily with the number of medications used and age in older people in Taiwan. Cerebrovascular disease, diabetes mellitus, chronic kidney disease and hypertension might also correlate with the risk of dementia.
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Affiliation(s)
- Shih-Wei Lai
- School of Medicine, China Medical University, Taichung, Taiwan
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Rodríguez-Sánchez E, Mora-Simón S, Patino-Alonso MC, García-García R, Escribano-Hernández A, García-Ortiz L, Perea-Bartolomé MV, Gómez-Marcos MA. Prevalence of cognitive impairment in individuals aged over 65 in an urban area: DERIVA study. BMC Neurol 2011; 11:147. [PMID: 22093337 PMCID: PMC3226440 DOI: 10.1186/1471-2377-11-147] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 11/17/2011] [Indexed: 11/27/2022] Open
Abstract
Background Few data are available on the prevalence of cognitive impairment (CI) in Spain, and the existing information shows important variations depending on the geographical setting and the methodology employed. The aim of this study was to determine the prevalence of CI in individuals aged over 65 in an urban area, and to analyze its associated risk factors. Methods Design: A descriptive, cross-sectional, home questionnaire-based study; Setting: Populational, urban setting. Participants: The reference population comprised over-65s living in the city of Salamanca (Spain) in 2009. Randomized sampling stratified according to health district was carried out, and a total of 480 people were selected. In all, 327 patients were interviewed (68.10%), with a mean age of 76.35 years (SD: 7.33). Women accounted for 64.5% of the total. Measurements: A home health questionnaire was used to obtain the following data: age, sex, educational level, family structure, morbidity and functionality. All participants completed a neuropsychological test battery. The prevalence data were compared with those of the European population, with direct adjustment for age and sex. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment - no dementia (CIND), and dementia. Results The prevalence of CI among these over-65s was 19% (14.7% CIND and 4.3% dementia). The age-and sex-adjusted global prevalence of CI was 14.9%. CI increased with age (p < 0.001) and decreased with increasing educational level (p < 0.001). Significant risk factors were found with the multivariate analyses: age (OR = 1.08, 95%CI: 1.03-1.12), anxiety-depression (OR = 3.47, 95%CI: 1.61-7.51) and diabetes (OR = 2.07, 95%CI: 1.02-4.18). In turn, years of education was found to be a protective factor (OR = 0.79, 95%CI: 0.70-0.90). Although CI was more frequent among women and in people living without a partner, these characteristics were not significantly associated with CI risk. Conclusions The observed raw prevalence of CI was 19% (14.9% after adjusting for age and sex). Older age and the presence of diabetes and anxiety-depression increased the risk of CI, while higher educational level reduced the risk.
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Affiliation(s)
- Emiliano Rodríguez-Sánchez
- Primary care research unit of La Alamedilla Health Center, Castilla y León Health Service- SACYL, Salamanca, Spain.
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Sharp SI, Aarsland D, Day S, Sønnesyn H, Ballard C. Hypertension is a potential risk factor for vascular dementia: systematic review. Int J Geriatr Psychiatry 2011; 26:661-9. [PMID: 21495075 DOI: 10.1002/gps.2572] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 04/16/2010] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the study was to conduct a meta-analysis of epidemiological and case control studies to determine whether arterial hypertension is specifically associated with an increased risk of vascular dementia (VaD). DESIGN Longitudinal and cross-sectional prospective studies using operationalised criteria to define VaD and hypertension, with a normal control comparison group were systematically reviewed. Cochrane Library, Embase, Medline, and PsycInfo data sources were searched along with reference lists of included articles and reviews. Original, prevalence or incidence studies were included if operationalised criteria for hypertension and VaD as well as number of cases with and without hypertension in VaD and non-demented groups were provided. Intervention studies and post-stroke and CADASIL studies were excluded. RESULTS Eleven studies recruiting either volunteers or clinical patients, or which were population-based, examined a total of 768 people with VaD and 9857 control cases. A meta-analysis of the six longitudinal studies showed that hypertension was significantly associated with increased risk of incident VaD (odds ratio, OR: 1.59, CI: 1.29-1.95, p < 0.0001). A similar association between hypertension and the risk of prevalent VaD was found in the five cross-sectional studies (OR: 4.84, CI: 3.52-6.67, p < 0.00001). CONCLUSIONS Hypertension significantly increases the risk of vascular dementia. The current meta-analysis highlights the potential importance of rigorous treatment of hypertension as a key measure to help prevent the development of VaD.
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Affiliation(s)
- Sally I Sharp
- Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, UK
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Sasaki Y, Marioni R, Kasai M, Ishii H, Yamaguchi S, Meguro K. Chronic kidney disease: a risk factor for dementia onset: a population-based study. The Osaki-Tajiri Project. J Am Geriatr Soc 2011; 59:1175-81. [PMID: 21668914 DOI: 10.1111/j.1532-5415.2011.03477.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the relationship between the incidence of dementia and chronic kidney disease (CKD). DESIGN Longitudinal data analyses. SETTING Baseline data and follow-up data from the Osaki-Tajiri Project. PARTICIPANTS The Tajiri Project dementia prevalence study in 1998 involved 497 community-dwelling, older men and women (346 with Clinical Dementia Rating score (CDR) of 0 (healthy), 119 with a CDR of 0.5 (questionable dementia), and 32 with a CDR of 1 or greater (dementia)). Two hundred fifty-four participants with CDR of 0 and 0.5 who were reclassified as converters (n=28) or nonconverters (n=230) to dementia in the incidence study in 2003 were followed. MEASUREMENTS The prevalence of CKD and the onset of dementia were retrospectively analyzed, and the effects of other vascular risk factors on converters and CKD were analyzed. RESULTS Weighted logistic regression showed CKD to be significantly associated with incident dementia after adjustment for age, sex, education, hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, and anemia. The odds ratio for conversion to dementia for those with CKD compared to those without was 5.3 (95% confidence interval=1.7, 16.2). Apart from dyslipidemia, there were no associations between dementia and the other vascular risk factors. CONCLUSION CKD was strongly associated with the incidence of dementia independent of age, sex, education, and other vascular risk factors.
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Affiliation(s)
- Yumi Sasaki
- Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Gironi M, Bianchi A, Russo A, Alberoni M, Ceresa L, Angelini A, Cursano C, Mariani E, Nemni R, Kullmann C, Farina E, Martinelli Boneschi F. Oxidative Imbalance in Different Neurodegenerative Diseases with Memory Impairment. NEURODEGENER DIS 2011; 8:129-37. [DOI: 10.1159/000319452] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 07/12/2010] [Indexed: 11/19/2022] Open
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Lee YK, Sung MR, Lee DY. Comorbidity and Health Habits of Seoul City Elders with Dementia. J Korean Acad Nurs 2011; 41:411-22. [PMID: 21804350 DOI: 10.4040/jkan.2011.41.3.411] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoon Kyoung Lee
- Assistant Professor, Red Cross College of Nursing, Seoul, Korea
| | - Mi Ra Sung
- Secretary General, Seoul Dementia Center, Seoul, Korea
| | - Dong Young Lee
- Director, Seoul Dementia Center·Professor, Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
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Abstract
This article focuses on social and psychological risk factors for Alzheimer’s
disease, dementia, and cognitive impairment and presents some key points for
prevention in developing countries based on previous studies, a social science
theory, and our preliminary survey. Previous population-based studies found that
educational and occupational attainment, income, participation in social and
mental activities, and psychological distress were associated with dementia
risk. According to the theory of path dependence, earlier factors largely
determine successive ones, where education is one of these early experiences in
life. Our preliminary survey suggested that education sets a path that several
psychosocial risk factors are dependent on. The expansion of basic education is
indispensable. Resources for prevention should be concentrated on individuals
with a low level of education. In order to break from a path creating
self-reinforcement of risk factors, it is necessary to implement early and
active interventions.
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Affiliation(s)
- Hiroko Matsuoka
- MA, School of Nursing & Health, Aichi Prefectural University, Nagoya, Japan
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Urine formaldehyde level is inversely correlated to mini mental state examination scores in senile dementia. Neurobiol Aging 2011; 32:31-41. [DOI: 10.1016/j.neurobiolaging.2009.07.013] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 07/09/2009] [Accepted: 07/26/2009] [Indexed: 02/02/2023]
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Weijenberg R, Scherder E, Lobbezoo F. Mastication for the mind—The relationship between mastication and cognition in ageing and dementia. Neurosci Biobehav Rev 2011; 35:483-97. [DOI: 10.1016/j.neubiorev.2010.06.002] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 06/05/2010] [Accepted: 06/08/2010] [Indexed: 01/14/2023]
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Doruk H, Naharci MI, Bozoglu E, Isik AT, Kilic S. The relationship between body mass index and incidental mild cognitive impairment, Alzheimer's disease and vascular dementia in elderly. J Nutr Health Aging 2010; 14:834-8. [PMID: 21125201 DOI: 10.1007/s12603-010-0113-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the association between body mass index (BMI) and cognitive decline (CD) due to Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD), and Vascular Dementia (VaD). DESIGN AND SETTING The subjects aged ≥ 65 years were recruited prospectively from the Geriatrics Clinic of Gulhane Medical School, between 2004 and 2008 years. PARTICIPANTS 1302 patients were included in the study. MEASUREMENTS Cognitive status, clinical diagnosis of CD (MCI, AD, and VaD) and clinical and environmental risk factors were evaluated by comprehensive geriatric assesment. Finally, the subjects were categorized into two groups according to having CD or not. RESULTS 905 (69.5%) subjects were not having CD whereas 397 (30.5%) patients with CD. Of the patients with CD, 140 (10.4%) had MCI, 227 (16.9%) AD, and 30 (2.2%) VaD. After adjustment for confounding with a model for multiple regression analysis, age (OR=1.054; CI:1.027-1.083; p < 0.001) and family history of dementia (OR=1.662; CI:1.038-2.660; p=0.034) were found to be independent risk factors for CD. Also, overweight (OR=0.594; CI:0.370-0.952; p=0.03) and obese (OR=0.396; CI:0.242-0.649; p < 0.001), and high education level (OR=0.640; CI:0.451-0.908; p=0.012) were found to be independent protective factors for CD. CONCLUSIONS We found the risk of CD decreases in overweight and obese elderly. The results indicate that the primary prevention should not only consider risk factors, but must also take anthropometric data into consideration in order to identify persons at high risk for CD.
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Affiliation(s)
- H Doruk
- Gulhane School of Medicine, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey.
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Sierksma AS, van den Hove DL, Steinbusch HW, Prickaerts J. Major depression, cognitive dysfunction and Alzheimer's disease: Is there a link? Eur J Pharmacol 2010; 626:72-82. [DOI: 10.1016/j.ejphar.2009.10.021] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 09/29/2009] [Accepted: 10/06/2009] [Indexed: 11/30/2022]
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de Pedro-Cuesta J, Virués-Ortega J, Vega S, Seijo-Martínez M, Saz P, Rodríguez F, Rodríguez-Laso A, Reñé R, de las Heras SP, Mateos R, Martínez-Martín P, Manubens JM, Mahillo-Fernandez I, López-Pousa S, Lobo A, Reglà JL, Gascón J, García FJ, Fernández-Martínez M, Boix R, Bermejo-Pareja F, Bergareche A, Benito-León J, de Arce A, del Barrio JL. Prevalence of dementia and major dementia subtypes in Spanish populations: a reanalysis of dementia prevalence surveys, 1990-2008. BMC Neurol 2009; 9:55. [PMID: 19840375 PMCID: PMC2770986 DOI: 10.1186/1471-2377-9-55] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Accepted: 10/19/2009] [Indexed: 12/04/2022] Open
Abstract
Background This study describes the prevalence of dementia and major dementia subtypes in Spanish elderly. Methods We identified screening surveys, both published and unpublished, in Spanish populations, which fulfilled specific quality criteria and targeted prevalence of dementia in populations aged 70 years and above. Surveys covering 13 geographically different populations were selected (prevalence period: 1990-2008). Authors of original surveys provided methodological details of their studies through a systematic questionnaire and also raw age-specific data. Prevalence data were compared using direct adjustment and logistic regression. Results The reanalyzed study population (aged 70 year and above) was composed of Central and North-Eastern Spanish sub-populations obtained from 9 surveys and totaled 12,232 persons and 1,194 cases of dementia (707 of Alzheimer's disease, 238 of vascular dementia). Results showed high variation in age- and sex-specific prevalence across studies. The reanalyzed prevalence of dementia was significantly higher in women; increased with age, particularly for Alzheimer's disease; and displayed a significant geographical variation among men. Prevalence was lowest in surveys reporting participation below 85%, studies referred to urban-mixed populations and populations diagnosed by psychiatrists. Conclusion Prevalence of dementia and Alzheimer's disease in Central and North-Eastern Spain is higher in females, increases with age, and displays considerable geographic variation that may be method-related. People suffering from dementia and Alzheimer's disease in Spain may approach 600,000 and 400,000 respectively. However, existing studies may not be completely appropriate to infer prevalence of dementia and its subtypes in Spain until surveys in Southern Spain are conducted.
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Affiliation(s)
- Jesús de Pedro-Cuesta
- National Centre for Epidemiology, CIBERNED and Alzheimer' Disease Research Unit, Carlos III Institute of Public Health, Madrid, Spain.
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Abstract
Depression and cognitive impairment are both common conditions in old age, and frequently occur together. However, accurate figures of the co-occurrence are not available. The inter-relationship between the two clinical entities is still complex and not well understood. Clearly depression can be a psychological reaction to cognitive decline, and thus may also appear as an early symptom in dementing individuals. However, recent data suggest that depression, and in particularly late-life depression, can also be a risk factor for Alzheimer's disease (AD). The relationship between the two clinical entities should be seen in view of observations of white matter changes both in AD and in depression. Since these white matter changes are thought to frequently reflect vascular changes, the concept of "vascular depression" has been advanced. Vascular changes in the brain occur commonly in demented individuals and conversely depression is frequent co-occurrence in vascular disease. Additionally neurotransmitter loss may occur in both, particularly monoaminergic disturbances which is characteristic of depression but may occur also in AD. The same is true for hippocampal atrophy, which is characteristic of AD but has also been described in depression. Here we review the complex relationships between dementia and depression and suggest that excessive release of corticosteroids may have a neurotoxic effects.
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Affiliation(s)
- Amos D Korczyn
- Tel-Aviv University Medical School, Sieratzki Chair of Neurology, Ramat-Aviv 69978, Israel.
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