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Barbosa BJAP, Souza-Talarico JND, Jesus MCFD, Mota GPS, Oliveira MOD, Cassimiro L, Avolio IMB, Trés ES, Borges CR, Teixeira TBM, Brucki SMD. Allostatic load measures in older adults with subjective cognitive decline and mild cognitive impairment: A cross-sectional analysis from the Brazilian Memory and Aging Study. Clin Neurol Neurosurg 2024; 243:108365. [PMID: 38852227 DOI: 10.1016/j.clineuro.2024.108365] [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: 04/08/2024] [Revised: 05/27/2024] [Accepted: 06/01/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION An increasing body of research suggests that stress and allostatic load are related to cognitive dysfunction and neurodegeneration. OBJECTIVES to determine the relationship between allostatic load (AL) and cognitive status in older adults classified with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). METHODOLOGY Using the Brazilian Memory and Aging Study (BRAMS) database, we analyzed data from 57 older adults with SCD and MCI. Blood neuroendocrine (cortisol, DHEA-s), inflammatory (C-reactive protein, fibrinogen), metabolic (HbA1c, HDL-cholesterol, total cholesterol, creatinine), and cardiovascular (blood pressure, waist/hip ratio) were transformed into an AL index. RESULTS Despite a significant difference in the univariate analysis between waist/hip ratio (0.94 in the MCI group vs. 0, 88 in the SCD group, p = 0.03), total cholesterol levels (194 vs. 160, p = 0.02), and AL index (36.9 % in the MCI group vs. 27.2 % in the SCD group, p = 0.04), AL was not associated with SCD or MCI in the multivariate analysis. CONCLUSION Our data suggest that different profiles of AL in MCI compared to individuals with SCD could be due to cofounding factors. These findings need to be confirmed in longitudinal studies investigating profiles of AL changes at preclinical and prodromal stages of Alzheimer's disease.
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Affiliation(s)
- Breno José Alencar Pires Barbosa
- University of São Paulo, School of Medicine, Department of Neurology, São Paulo, Brazil; Federal University of Pernambuco, Centro de Ciências Médicas, Área Acadêmica de Neuropsiquiatria, Recife, Brazil.
| | - Juliana Nery de Souza-Talarico
- University of São Paulo, School of Nursing, Department of Medical-Surgical Nursing, São Paulo, Brazil; The University of Iowa, College of Nursing, IA, USA.
| | | | | | | | - Luciana Cassimiro
- University of São Paulo, School of Medicine, Department of Neurology, São Paulo, Brazil.
| | | | | | - Conrado Regis Borges
- University of São Paulo, School of Medicine, Department of Neurology, São Paulo, Brazil.
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Rojas-Rozo L, Lee L, Khanassov V, Sivananthan S, Ismail Z, Gauthier S, Vedel I. Latest Canadian Consensus Conference on the Diagnosis and Treatment of Dementia: What's in It for Primary Care? Can J Aging 2024; 43:185-196. [PMID: 37855225 DOI: 10.1017/s0714980823000521] [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: 10/20/2023] Open
Abstract
In 2020, the fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD5) published up-to-date recommendations for the clinical management of persons living with dementia (PLWD) and their caregivers. During the CCCDTD5 meetings, a list of recommendations for dementia care was compiled. With the aid of family physicians and the Canadian Consortium on Neurodegeneration in Aging, we selected the most relevant CCCDTD5 recommendations for primary care and tailored and summarized them in the present manuscript to facilitate their reference and use. These recommendations focus on (a) risk reduction, (b) screening and diagnosis, (c) deprescription of dementia medications, and (d) non-pharmacological interventions. The development of recommendations for the ongoing management of dementia is an iterative process as new evidence on interventions for dementia is published. These recommendations are important in the primary care setting as the entry point for PLWD into the health system.
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Affiliation(s)
- Laura Rojas-Rozo
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Linda Lee
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | | | | | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Serge Gauthier
- Departments of Neurology and Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
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Schroeder MW, Waring ME, Fowler NR, Mace RA, Pagoto SL. Association Between Subjective Cognitive Decline and Twice-Weekly Muscle-Strengthening Activities in Middle-Aged and Older US Adults: An Analysis of the 2019 Behavioral Risk Factor Surveillance System. Am J Health Promot 2024; 38:615-624. [PMID: 38226478 PMCID: PMC11123578 DOI: 10.1177/08901171231224517] [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: 01/17/2024]
Abstract
PURPOSE Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD. DESIGN Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. SAMPLE 114 164 respondents, representing approximately 59 million US adults aged ≥45. MEASURES SCD was indicated if the respondent reported confusion or memory loss during the past 12 months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week). ANALYSIS Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C. RESULTS US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0). CONCLUSION Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.
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Affiliation(s)
| | - Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Nicole R. Fowler
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN, USA
| | - Ryan A. Mace
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Pereira ML, Caramelli P, Sá VMD, Rocha PHM, Oliveira JPGD, Amorim RPD, Silva EVD, Delboni VS, Barbosa MT, Miranda LFJRD, de Souza LC. Memory complaint in a middle-income country: a four-year longitudinal study in a cohort with low-education. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-9. [PMID: 38849124 DOI: 10.1055/s-0044-1787138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
BACKGROUND Memory complaints are frequent in older adults and are associated with higher risk of cognitive decline. OBJECTIVE To investigate the functional outcome of individuals with memory complaints followed up at primary care centers. METHODS Data were collected between 2016 e 2020 in primary health care centers in Brazil. Patients underwent the Brief Cognitive Screening Battery, and the Functional Activities Questionnaire. RESULTS The initial sample (2016) comprised 91 individuals classified into those with subjective cognitive decline (SCD, n = 15), mild cognitive impairment (MCI, n = 45), or dementia (n = 31). During follow-up, 8 individuals (8.8% of the initial sample) died and 26 (28.5% of the initial sample) were not found. Fifty-seven participants underwent clinical reassessment. Of 15 individuals with SCD, 7 were not found (46.7%), 4 (26.7%) progressed to MCI, and 4 (26.7%) remained stable. Of 45 individuals with MCI, 11 were not found (24.4%), 2 (4.4%) died, 6 (13.4%) progressed to dementia, 12 (26.7%) regressed to SCD, and 14 (31.1%) remained stable. Of 31 individuals with dementia, 8 were not found (25.8%), 6 (19.4%) died, 2 (6.5%) regressed to SCD, 7 (22.6%) regressed to MCI, and 8 remained stable (25.8%). Clinical improvement was due to the treatment of reversible causes, such as B12 hypovitaminosis and mood disorders. Older age, lower Mini-Mental State Examination, and higher scores of memory complaint, but not the use of benzodiazepines and of proton pump inhibitors, were predictors of functional status. CONCLUSION Despite their limits (short sample size, missing data), these results support the idea that adequate screening, follow-up, and treatment of reversible causes of dementia in primary care are essential.
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Affiliation(s)
- Marcos Leandro Pereira
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brazil
- Khronus Saúde e Educação Ltda, Instituto Khronus de Desenvolvimento Humano, Patos de Minas MG, Brazil
- Centro Universitário de Patos de Minas, Curso de Medicina, Patos de Minas MG, Brazil
| | - Paulo Caramelli
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | - Vannessa Marinara de Sá
- Khronus Saúde e Educação Ltda, Instituto Khronus de Desenvolvimento Humano, Patos de Minas MG, Brazil
| | | | | | | | - Elvis Vieira da Silva
- Centro Universitário de Patos de Minas, Curso de Medicina, Patos de Minas MG, Brazil
| | | | - Maira Tonidandel Barbosa
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
| | | | - Leonardo Cruz de Souza
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Neurociências, Belo Horizonte MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte MG, Brazil
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Pinyopornpanish K, Buawangpong N, Soontornpun A, Thaikla K, Pateekhum C, Nantsupawat N, Wiwatkunupakarn N, Jiraporncharoen W, Angkurawaranon C. A household survey of the prevalence of subjective cognitive decline and mild cognitive impairment among urban community-dwelling adults aged 30 to 65. Sci Rep 2024; 14:7783. [PMID: 38565884 PMCID: PMC10987517 DOI: 10.1038/s41598-024-58150-3] [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: 09/22/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
While it is possible to detect cognitive decline before the age of 60, and there is a report indicating that certain cognitive abilities peak in one's 30s, the evidence regarding cognitive problems in populations younger than 65 years is scarce. This study aims to (1) determine the proportion of community-dwelling adults with different cognitive status, and (2) determine the prevalence of neuropsychiatric behaviors. A population-based survey was conducted in Chiang Mai, Thailand. Individuals aged 30 to 65 were recruited and assessed for demographic data, memory complaints, cognitive performance, and neuropsychiatric symptoms using self-reported questionnaires. In a total of 539 participants, 33.95% had mild cognitive impairment (MCI), 7.05% had subjective cognitive decline (SCD), and 52.50% had neuropsychiatric symptoms. The risk of MCI increased with age, and neuropsychiatric symptoms were significantly higher in those with MCI or SCD than in those without (p < 0.001). The most common complaints were sleep problems, anxiety, and irritability. Screening for MCI in adults aged < 65 years might be useful. However, further investigation on the appropriate age to screen and the program's cost-effectiveness is suggested.
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Affiliation(s)
- Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Atiwat Soontornpun
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kanittha Thaikla
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chanapat Pateekhum
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Nopakoon Nantsupawat
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nutchar Wiwatkunupakarn
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand.
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Kim B, Hu J. The Effectiveness of Cognitive-Focused Interventions for Adults With Diabetes: A Systematic Review. West J Nurs Res 2024; 46:236-247. [PMID: 38205721 DOI: 10.1177/01939459231221939] [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: 01/12/2024]
Abstract
BACKGROUND Adults with diabetes and impaired memory and executive functions are more likely to experience difficulties in diabetes self-management and achieving glycemic targets. The purpose of this systematic review was to evaluate the evidence of the effects of cognitive-focused interventions on cognitive ability, diabetes self-management, and management of glycemic levels for middle-aged adults and older adults with diabetes. METHODS A systematic review of randomized controlled/clinical trials published in English between 2012 and 2022 was conducted. A search was performed using 5 databases (PubMed, CINAHL, Embase, Web of Science, and Scopus) in addition to hand-searching. The search terms included diabetes, adults, cognitive-focused intervention, cognition, self-management, and hemoglobin A1C (HbA1C). RESULTS Eleven studies met the inclusion criteria. Cognitive ability and diabetes self-management were assessed using different measurements, and glycemic levels were measured with HbA1C. Nine studies applied cognitive training, one provided working memory training, and one used occupational therapy. Eight studies combined cognitive training with a co-intervention, including self-efficacy, lifestyle management, physical training, chronic disease self-management program, square-stepping exercise, psychoeducational intervention, and empowerment. Eight studies showed statistically significant improvements in at least one cognitive domain. CONCLUSIONS Cognitive-focused interventions have a positive effect on improving memory and executive function. However, the evidence of cognitive-focused interventions on diabetes self-management and glycemic levels has not been established. Future studies to improve cognition using effective strategies to improve cognitive function enhancing diabetes self-management behaviors and managing glycemic levels are warranted.
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Affiliation(s)
- Bohyun Kim
- The Ohio State University, College of Nursing, Columbus, OH, USA
| | - Jie Hu
- The Ohio State University, College of Nursing, Columbus, OH, USA
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Pecchinenda A, Yankouskaya A, Boccia M, Piccardi L, Guariglia C, Giannini AM. Exploring the relationship between perceived loneliness and subjective cognitive decline in older individuals. Aging Ment Health 2024; 28:73-82. [PMID: 37540497 DOI: 10.1080/13607863.2023.2242291] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/12/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE Loneliness has been associated to a greater risk of cognitive decline and dementia in older individuals. However, evidence on whether this association also exists for older individuals who complain of cognitive problems is limited. We conducted a survey to examine the association between subjective cognitive decline in the working memory domain, perceived loneliness, depression, anxiety, and stress in older individuals with different profiles. METHODS A total of 302 healthy, old individuals completed 3 questionnaires to assess subjective cognitive problems in attention, executive functions, storage, depression, anxiety, stress, and perceived loneliness. RESULTS We conducted a cluster analysis and 3 clusters of individuals with different profiles emerged. Individuals with greater subjective cognitive problems (cluster 1) in the attention and storage domains, reported higher perceived loneliness and stress but not depression. In contrast, individuals with the least subjective cognitive problems (cluster 3) in the storage domain, reported lower perceived loneliness. CONCLUSIONS Individuals with higher subjective cognitive decline also report higher levels of perceived loneliness but not more depression than their peers. However, this correlation is present only for individuals with mild subjective cognitive decline (cluster 2). The implications for future research and interventions are discussed.
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Affiliation(s)
- Anna Pecchinenda
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Laura Piccardi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- San Raffaele Cassino Hospital, Cassino, FR, Italy
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Anna Maria Giannini
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
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Nakhla MZ, Bangen KJ, Schiehser DM, Roesch S, Zlatar ZZ. Greater subjective cognitive decline severity is associated with worse memory performance and lower entorhinal cerebral blood flow in healthy older adults. J Int Neuropsychol Soc 2024; 30:1-10. [PMID: 36781410 PMCID: PMC10423746 DOI: 10.1017/s1355617723000115] [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] [Indexed: 02/15/2023]
Abstract
OBJECTIVE Subjective cognitive decline (SCD) is a potential early risk marker for Alzheimer's disease (AD), but its utility may vary across individuals. We investigated the relationship of SCD severity with memory function and cerebral blood flow (CBF) in areas of the middle temporal lobe (MTL) in a cognitively normal and overall healthy sample of older adults. Exploratory analyses examined if the association of SCD severity with memory and MTL CBF was different in those with lower and higher cardiovascular disease (CVD) risk status. METHODS Fifty-two community-dwelling older adults underwent magnetic resonance imaging, neuropsychological testing, and were administered the Everyday Cognition Scale (ECog) to measure SCD. Regression models investigated whether ECog scores were associated with memory performance and MTL CBF, followed by similar exploratory regressions stratified by CVD risk status (i.e., lower vs higher stroke risk). RESULTS Higher ECog scores were associated with lower objective memory performance and lower entorhinal cortex CBF after adjusting for demographics and mood. In exploratory stratified analyses, these associations remained significant in the higher stroke risk group only. CONCLUSIONS Our preliminary findings suggest that SCD severity is associated with cognition and brain markers of preclinical AD in otherwise healthy older adults with overall low CVD burden and that this relationship may be stronger for individuals with higher stroke risk, although larger studies with more diverse samples are needed to confirm these findings. Our results shed light on individual characteristics that may increase the utility of SCD as an early risk marker of cognitive decline.
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Affiliation(s)
- Marina Z. Nakhla
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Katherine J. Bangen
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Dawn M. Schiehser
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Scott Roesch
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, 92182
| | - Zvinka Z. Zlatar
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
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Chan FHF, Goh ZZS, Zhu X, Tudor Car L, Newman S, Khan BA, Griva K. Subjective cognitive complaints in end-stage renal disease: a systematic review and meta-analysis. Health Psychol Rev 2023; 17:614-640. [PMID: 36200562 DOI: 10.1080/17437199.2022.2132980] [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: 11/08/2021] [Accepted: 09/30/2022] [Indexed: 11/04/2022]
Abstract
Cognitive impairment is common in patients with end-stage renal disease (ESRD) and is associated with compromised quality of life and functional capacity, as well as worse clinical outcomes. Most previous research and reviews in this area were focused on objective cognitive impairment, whereas patients' subjective cognitive complaints (SCCs) have been less well-understood. This systematic review aimed to provide a broad overview of what is known about SCCs in adult ESRD patients. Electronic databases were searched from inception to January 2022, which identified 221 relevant studies. SCCs appear to be highly prevalent in dialysis patients and less so in those who received kidney transplantation. A random-effects meta-analysis also shows that haemodialysis patients reported significantly more SCCs than peritoneal dialysis patients (standardised mean difference -0.20, 95% confidence interval -0.38 to -0.03). Synthesis of longitudinal studies suggests that SCCs remain stable on maintenance dialysis treatment but may reduce upon receipt of kidney transplant. Furthermore, SCCs in ESRD patients have been consistently associated with hospitalisation, depression, anxiety, fatigue, and poorer quality of life. There is limited data supporting a strong relation between objective and subjective cognition but preliminary evidence suggests that this association may be domain-specific. Methodological limitations and future research directions are discussed.
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Affiliation(s)
- Frederick H F Chan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Zack Z S Goh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Xiaoli Zhu
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Nursing Services, National Healthcare Group Polyclinics, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
| | - Stanton Newman
- School of Health Sciences, Division of Health Services Research and Management, City University of London, London, UK
| | - Behram A Khan
- National Kidney Foundation, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Qin H, Zhou L, Haque FT, Martin-Jimenez C, Trang A, Benveniste EN, Wang Q. Diverse signaling mechanisms and heterogeneity of astrocyte reactivity in Alzheimer's disease. J Neurochem 2023. [PMID: 37932959 DOI: 10.1111/jnc.16002] [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: 08/04/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023]
Abstract
Alzheimer's disease (AD) affects various brain cell types, including astrocytes, which are the most abundant cell types in the central nervous system (CNS). Astrocytes not only provide homeostatic support to neurons but also actively regulate synaptic signaling and functions and become reactive in response to CNS insults through diverse signaling pathways including the JAK/STAT, NF-κB, and GPCR-elicited pathways. The advent of new technology for transcriptomic profiling at the single-cell level has led to increasing recognition of the highly versatile nature of reactive astrocytes and the context-dependent specificity of astrocyte reactivity. In AD, reactive astrocytes have long been observed in senile plaques and have recently been suggested to play a role in AD pathogenesis and progression. However, the precise contributions of reactive astrocytes to AD remain elusive, and targeting this complex cell population for AD treatment poses significant challenges. In this review, we summarize the current understanding of astrocyte reactivity and its role in AD, with a particular focus on the signaling pathways that promote astrocyte reactivity and the heterogeneity of reactive astrocytes. Furthermore, we explore potential implications for the development of therapeutics for AD. Our objective is to shed light on the complex involvement of astrocytes in AD and offer insights into potential therapeutic targets and strategies for treating and managing this devastating neurodegenerative disorder.
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Affiliation(s)
- Hongwei Qin
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lianna Zhou
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Faris T Haque
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cynthia Martin-Jimenez
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Amy Trang
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Etty N Benveniste
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Qin Wang
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
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Harrington EE, Graham-Engeland JE, Sliwinski MJ, Van Bogart K, Mogle JA, Katz MJ, Lipton RB, Engeland CG. Older adults' self-reported prospective memory lapses in everyday life: Connections to inflammation and gender. J Psychosom Res 2023; 174:111489. [PMID: 37690333 PMCID: PMC10591850 DOI: 10.1016/j.jpsychores.2023.111489] [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: 05/04/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Limited research has focused on the association between inflammatory markers and features of subjective cognitive functioning among older adults. The present work examined links between inflammation and a specific subjective cognitive report: prospective memory (PM), or our memory for future intentions, such as attending an appointment or taking medication. METHOD We assessed self-reported PM lapses using a two-week ecological momentary assessment (EMA) diary protocol via smartphone as well as levels of blood-based inflammation among 231 dementia-free older adults (70-90 years, 66% women) enrolled in the Einstein Aging Study. RESULTS Overall, PM lapses were largely unrelated to inflammatory markers. However, a significant gender difference was observed in the link between basal levels of interleukin (IL)-8 and PM lapses: higher levels of basal IL-8 were associated with more PM lapses among men (estimate = 0.98, 95%CI: [0.43, 1.53], p < .001) but not women (estimate = -0.03, 95%CI: [-0.45, 0.39], p = .826). No other significant relationships between PM lapses and basal or stimulated (ex vivo) cytokine levels (IL-1β, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha [TNF-α]) or C-reactive protein (CRP) emerged. CONCLUSION Elevated levels of IL-8 in older men may possibly be an early indicator of neurodegeneration that relates to PM performance. Future studies should continue to examine PM and inflammation across genders to identify possible mechanisms through which these constructs may indicate neurodegeneration and dementia risk.
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Affiliation(s)
- Erin E Harrington
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA; Center for Healthy Aging, The Pennsylvania State University, University Park, PA 16802, USA; Department of Psychology, University of Wyoming, Laramie, WY 82070, USA.
| | - Jennifer E Graham-Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA; Center for Healthy Aging, The Pennsylvania State University, University Park, PA 16802, USA
| | - Martin J Sliwinski
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA 16802, USA; Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA 16802, USA
| | - Karina Van Bogart
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
| | | | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Richard B Lipton
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Christopher G Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA; Center for Healthy Aging, The Pennsylvania State University, University Park, PA 16802, USA; Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA
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12
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Hoffmeister JR, Roye S, Copeland CT, Linck JF. Adaptive Functioning Among Older Adults: The Essence of Information Processing Speed in Executive Functioning. Arch Clin Neuropsychol 2023; 38:1082-1090. [PMID: 37114743 DOI: 10.1093/arclin/acad031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE The current study investigated the degree to which information processing speed mediates the association between executive functioning and adaptive functioning among older adults. METHOD Cases (N = 239) were selected from a clinical database of neuropsychological evaluations. Inclusion criteria were age 60+ (M = 74.0, standard deviation = 6.9) and completion of relevant study measures. Participants were majority White (93%) women (53.1%). The Texas Functional Living Scale was used as a performance-based measure of adaptive functioning. Information processing speed was measured using the Coding subtest from the Repeatable Battery for the Assessment of Neuropsychological Status. Executive functioning performance was quantified using part B of the Trail Making Test, Controlled Oral Word Association Test, and Similarities and Matrix Reasoning subtests from the Wechsler Abbreviated Scale of Intelligence, second edition. Mediation models were assessed with bootstrapped confidence intervals. RESULTS Information processing speed mediated all measures of executive functioning. Direct effects were significant for all models (ps < 0.03), suggesting that executive functioning maintained unique associations with adaptive functioning. Follow-up analyses indicated no evidence for moderation of the mediation models based on diagnostic group. Additional models with executive functioning mediating information processing speed and adaptive functioning revealed inconsistent mediation, with smaller effects. CONCLUSIONS Results highlight the importance of information processing speed in understanding real-world implications of pathological and non-pathological cognitive aging. Information processing speed mediated all relationships between executive functioning and adaptive functioning. Further investigation is warranted into the importance of processing speed in explaining associations of other cognitive domains with adaptive functioning.
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Affiliation(s)
- Jordan R Hoffmeister
- Department of Psychiatry and Behavioral Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Scott Roye
- Department of Psychiatry and Behavioral Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christopher T Copeland
- Department of Psychiatry and Behavioral Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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13
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Namirembe GE, Baker S, Albanese M, Mueller A, Qu JZ, Mekonnen J, Wiredu K, Westover MB, Houle TT, Akeju O. Association Between Postoperative Delirium and Long-Term Subjective Cognitive Decline in Older Patients Undergoing Cardiac Surgery: A Secondary Analysis of the Minimizing Intensive Care Unit Neurological Dysfunction with Dexmedetomidine-Induced Sleep Trial. J Cardiothorac Vasc Anesth 2023; 37:1700-1706. [PMID: 37217424 PMCID: PMC10524446 DOI: 10.1053/j.jvca.2023.04.035] [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: 03/03/2023] [Revised: 04/09/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVES This study aimed to evaluate whether a measure of subjective cognitive decline (SCD), the Patient-Reported Outcomes Measurement Information System (PROMIS) Applied Cognition-Abilities questionnaire, was associated with postoperative delirium. It was hypothesized that delirium during the surgical hospitalization would be associated with a decrease in subjective cognition up to 6 months after cardiac surgery. DESIGN This was a secondary analysis of data from the Minimizing Intensive Care Unit Neurological Dysfunction with Dexmedetomidine-induced Sleep randomized, placebo-controlled, parallel-arm superiority trial. SETTING Data from patients recruited between March 2017 and February 2022 at a tertiary medical center in Boston, Massachusetts were analyzed in February 2023. PARTICIPANTS Data from 337 patients aged 60 years or older who underwent cardiac surgery with cardiopulmonary bypass were included. INTERVENTIONS Patients were assessed preoperatively and postoperatively at 30, 90, and 180 days using the subjective PROMIS Applied Cognition-Abilities and telephonic Montreal Cognitive Assessment. MEASUREMENT AND MAIN RESULTS Postoperative delirium occurred within 3 days in 39 participants (11.6%). After adjusting for baseline function, participants who developed postoperative delirium self-reported worse cognitive function (mean difference [MD] -2.64 [95% CI -5.25, -0.04]; p = 0.047) up to 180 days after surgery, as compared with nondelirious patients. This finding was consistent with those obtained from objective t-MoCA assessments (MD -0.77 [95% CI -1.49, -0.04]; p = 0.04). CONCLUSIONS In this cohort of older patients undergoing cardiac surgery, in-hospital delirium was associated with SCD up to 180 days after surgery. This finding suggested that measures of SCD may enable population-level insights into the burden of cognitive decline associated with postoperative delirium.
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Affiliation(s)
- Grace E Namirembe
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Sarah Baker
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Marissa Albanese
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ariel Mueller
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jason Z Qu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jennifer Mekonnen
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kwame Wiredu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - M Brandon Westover
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Timothy T Houle
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Oluwaseun Akeju
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
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14
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Castro CB, Dias CB, Hillebrandt H, Sohrabi HR, Chatterjee P, Shah TM, Fuller SJ, Garg ML, Martins RN. Medium-chain fatty acids for the prevention or treatment of Alzheimer's disease: a systematic review and meta-analysis. Nutr Rev 2023; 81:1144-1162. [PMID: 36633304 DOI: 10.1093/nutrit/nuac104] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
CONTEXT In preclinical Alzheimer's disease (AD), the brain gradually becomes insulin resistant. As a result, brain glucose utilization is compromised, causing a cellular energy deficit that leads to the accumulation of free radicals, which increases inflammation and damages neurons. When glucose utilization is impaired, ketone bodies offer an alternative energy source. Ketone bodies are synthesized from fats, obtained from either the diet or adipose tissue. Dietary medium-chain fatty acids (MCFAs), which are preferentially metabolized into ketone bodies, have the potential to supply the insulin-resistant brain with energy. OBJECTIVE This systematic review and meta-analysis aims to review the effect of MCFA supplements on circulating ketone bodies and cognition in individuals with subjective cognitive decline, mild cognitive impairment, and AD. DATA SOURCES A comprehensive search of electronic databases was performed on August 12, 2019, to retrieve all publications meeting the inclusion criteria. Alerts were then set to identify any publications after the search date up until January 31, 2021. DATA EXTRACTION Data were extracted by 2 authors and assessed by a third. In total, 410 publications were identified, of which 16 (n = 17 studies) met the inclusion criteria. DATA ANALYSIS All studies assessing change in levels of blood ketone bodies due to MCFA supplementation (n = 12) reported a significant increase. Cognition outcomes (measured in 13 studies), however, varied, ranging from no improvement (n = 4 studies) to improvement (n = 8 studies) or improvement only in apolipoprotein E allele 4 (APOE ε4) noncarriers (n = 2 studies). One study reported an increase in regional cerebral blood flow in APOE ε4 noncarriers and another reported an increase in energy metabolism in the brain. CONCLUSION MCFA supplementation increases circulating ketone body levels, resulting in increased brain energy metabolism. Further research is required to determine whether this MCFA-mediated increase in brain energy metabolism improves cognition. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42019146967.
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Affiliation(s)
- Carolina B Castro
- Murdoch University Centre for Healthy Ageing, Murdoch University, Perth, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Perth, Western Australia, Australia
| | - Cintia B Dias
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Heidi Hillebrandt
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Hamid R Sohrabi
- Murdoch University Centre for Healthy Ageing, Murdoch University, Perth, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Perth, Western Australia, Australia
| | - Pratishtha Chatterjee
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Tejal M Shah
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
- Australian Alzheimer's Research Foundation, Perth, Western Australia, Australia
| | - Stephanie J Fuller
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Manohar L Garg
- Nutraceuticals Research Program, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ralph N Martins
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
- Australian Alzheimer's Research Foundation, Perth, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowen University, Perth, Western Australia, Australia
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15
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César-Freitas KG, Berardis ACP, Pretto TVM, Viagi AM, Lourençon V, Zanini LYK, Barbosa ICC, Machado RP, Cunha NGM, Watanabe MJL, Cecchini MA, Brucki SMD, Nitrini R. Follow-up of participants with subjective cognitive decline from Tremembé epidemiologic study, Brazil. Dement Neuropsychol 2023; 17:e20220064. [PMID: 37261255 PMCID: PMC10229081 DOI: 10.1590/1980-5764-dn-2022-0064] [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: 08/17/2022] [Revised: 02/07/2023] [Accepted: 03/09/2023] [Indexed: 06/02/2023] Open
Abstract
Subjective cognitive decline is defined as a self-perceived cognitive decline but with normal performance in neuropsychological assessments. Objective To verify the evolution of patients diagnosed with subjective cognitive decline compared to the cognitively normal group without any concern. Methods This is a follow-up study based on data analysis from the Tremembé epidemiologic study, in Brazil. The 211 individuals classified as cognitively normal and 174 diagnosed as having subjective cognitive decline at baseline were invited to participate. Results After a median follow-up time of five years, 108 subjective cognitive decline participants (62.0%) were reassessed. Of these, 58 (53.7%) kept this diagnosis, whereas 14 individuals (12.9%) progressed to mild cognitive impairment and 5 (4.6%) to dementia. In the cognitively normal group, 107 (50.7%) were reassessed, of which 51 (47.7%) were still classified likewise, 6 (5.6%) evolved to mild cognitive impairment and 9 (8.4%) to dementia. The presence of cognitive decline had a significant association with increasing age and depression symptoms. Considering the total number of baseline participants in each group: the subjective cognitive decline group showed higher percentage of mild cognitive impairment (p=0.022) and no difference was found in progression to dementia (p=0.468) between the groups after follow-up assessment. Conclusion Most subjective cognitive decline participants at baseline kept their cognitive complaint at follow-up and this group progressed more to mild cognitive impairment than the other group. No difference in the progression to dementia was found, despite the higher incidence of dementia in the cognitively normal group.
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Affiliation(s)
- Karolina Gouveia César-Freitas
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
- Universidade de Taubaté, Departamento de Medicina, Taubaté SP, Brazil
| | | | | | | | - Vitorio Lourençon
- Universidade de Taubaté, Departamento de Medicina, Taubaté SP, Brazil
| | | | | | | | | | | | - Mario Amore Cecchini
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
| | - Ricardo Nitrini
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
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16
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Ortner M, Lanz K, Goldhardt O, Müller-Sarnowski F, Diehl-Schmid J, Förstl H, Hedderich DM, Yakushev I, Logan CA, Weinberger JP, Simon M, Grimmer T. Elecsys Cerebrospinal Fluid Immunoassays Accurately Detect Alzheimer's Disease Regardless of Concomitant Small Vessel Disease. J Alzheimers Dis 2023:JAD221187. [PMID: 37212102 DOI: 10.3233/jad-221187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Differentiating dementia due to small vessel disease (SVD) from dementia due to Alzheimer's disease (AD) with concomitant SVD is challenging in clinical practice. Accurate and early diagnosis of AD is critical to delivering stratified patient care. OBJECTIVE We characterized the results of Elecsys ® cerebrospinal fluid (CSF) immunoassays (Roche Diagnostics International Ltd) in patients with early AD, diagnosed using core clinical criteria, with varying extent of SVD. METHODS Frozen CSF samples (n = 84) were measured using Elecsys β-Amyloid(1-42) (Aβ42), Phospho-Tau (181P) (pTau181), and Total-Tau (tTau) CSF immunoassays, adapted for use on the cobas ® e 411 analyzer (Roche Diagnostics International Ltd), and a robust prototype β-Amyloid(1-40) (Aβ40) CSF immunoassay. SVD was assessed by extent of white matter hyperintensities (WMH) using the lesion segmentation tool. Interrelations between WMH, biomarkers, fluorodeoxyglucose F18-positron emission tomography (FDG-PET), and other parameters (including age and Mini-Mental State examinations [MMSE]) were assessed using Spearman's correlation, sensitivity/specificity, and logistic/linear regression analyses. RESULTS The extent of WMH showed significant correlation with Aβ42/Aβ40 ratio (Rho=-0.250; p = 0.040), tTau (Rho = 0.292; p = 0.016), tTau/Aβ42 ratio (Rho = 0.247; p = 0.042), age (Rho = 0.373; p = 0.002), and MMSE (Rho=-0.410; p = 0.001). Sensitivity/specificity point estimates for Elecsys CSF immunoassays versus FDG-PET positivity for underlying AD pathophysiology were mostly comparable or greater in patients with high versus low WMH. WMH were not a significant predictor and did not interact with CSF biomarker positivity but modified the association between pTau181 and tTau. CONCLUSION Elecsys CSF immunoassays detect AD pathophysiology regardless of concomitant SVD and may help to identify patients with early dementia with underlying AD pathophysiology.
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Affiliation(s)
- Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Korbinian Lanz
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Felix Müller-Sarnowski
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Hans Förstl
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Dennis M Hedderich
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | | | | | - Maryline Simon
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
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17
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Pluim CF, Anzai JAU, Martinez JE, Munera D, Garza-Naveda AP, Vila-Castelar C, Guzmán-Vélez E, Ramirez-Gomez L, Bustin J, Serrano CM, Babulal GM, Okada de Oliveira M, Quiroz YT. Associations Among Loneliness, Purpose in Life and Subjective Cognitive Decline in Ethnoracially Diverse Older Adults Living in the United States. J Appl Gerontol 2023; 42:376-386. [PMID: 36396599 PMCID: PMC9679324 DOI: 10.1177/07334648221139479] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Subjective cognitive decline (SCD), which precedes Mild Cognitive Impairment and dementia, may be affected by purpose in life (PiL) and loneliness in older adults. We investigated associations among PiL, loneliness, and SCD in US Latino (n = 126), Black (n = 74), Asian (n = 33), and White (n = 637) adults. Higher PiL predicted lower SCD in all groups (p-values < .012), except Black participants. Lower loneliness predicted lower SCD in Latino and White groups (p-values < .05), and PiL moderated this association in White adults. PiL and loneliness may play important roles in cognitive decline. Differential predictors of SCD suggest differential targets for preventing cognitive decline and dementia across ethnoracial groups.
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Affiliation(s)
- Celina F. Pluim
- Department of Psychological and
Brain Sciences, Boston University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | - Juliana A. U. Anzai
- Department of Psychological and
Brain Sciences, Boston University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | - Jairo E. Martinez
- Department of Psychological and
Brain Sciences, Boston University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | - Diana Munera
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | - Ana Paola Garza-Naveda
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | - Clara Vila-Castelar
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | - Liliana Ramirez-Gomez
- Department of Neurology, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Cecilia M. Serrano
- Department of Neurology, Cesar Milstein Hospital, Buenos Aires, Argentina
| | | | - Maira Okada de Oliveira
- Department of Neurology, University of São Paulo, São Paulo, Brazil
- Department of Neurology, Hospital Santa Marcelina, São
Paulo, Brazil
| | - Yakeel T. Quiroz
- Department of Psychiatry, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General
Hospital, Harvard Medical School, Boston, MA, USA
- Yakeel T. Quiroz, Departments of Psychiatry
and Neurology, Massachusetts General Hospital, Harvard Medical School, 391st
Ave., Suite #101, Charlestown, Boston, MA 02129, USA.
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18
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Conserved reduction of m 6A RNA modifications during aging and neurodegeneration is linked to changes in synaptic transcripts. Proc Natl Acad Sci U S A 2023; 120:e2204933120. [PMID: 36812208 PMCID: PMC9992849 DOI: 10.1073/pnas.2204933120] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
N6-methyladenosine (m6A) regulates mRNA metabolism. While it has been implicated in the development of the mammalian brain and in cognition, the role of m6A in synaptic plasticity, especially during cognitive decline, is not fully understood. In this study, we employed methylated RNA immunoprecipitation sequencing to obtain the m6A epitranscriptome of the hippocampal subregions CA1, CA3, and the dentate gyrus and the anterior cingulate cortex (ACC) in young and aged mice. We observed a decrease in m6A levels in aged animals. Comparative analysis of cingulate cortex (CC) brain tissue from cognitively intact human subjects and Alzheimer's disease (AD) patients showed decreased m6A RNA methylation in AD patients. m6A changes common to brains of aged mice and AD patients were found in transcripts linked to synaptic function including calcium/calmodulin-dependent protein kinase 2 (CAMKII) and AMPA-selective glutamate receptor 1 (Glua1). We used proximity ligation assays to show that reduced m6A levels result in decreased synaptic protein synthesis as exemplified by CAMKII and GLUA1. Moreover, reduced m6A levels impaired synaptic function. Our results suggest that m6A RNA methylation controls synaptic protein synthesis and may play a role in cognitive decline associated with aging and AD.
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19
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Ben-Ami L, Ravona-Springer R, Tsarfaty G, Raizman R, Shumacher A, Sharvit-Ginon I, Greenbaum L, Bendlin BB, Okun E, Heymann A, Schnaider Beeri M, Livny A. Neural correlates of subjective cognitive decline in adults at high risk for Alzheimer's disease. Front Aging Neurosci 2023; 15:1067196. [PMID: 36819726 PMCID: PMC9930909 DOI: 10.3389/fnagi.2023.1067196] [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: 10/11/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Recently, interest has emerged in subjective cognitive decline (SCD) as a potential precursor to Alzheimer's disease (AD) dementia. Whether individuals with SCD harbor brain alterations in midlife, when AD-related pathology begins, is yet to be elucidated. Furthermore, the role of apolipoprotein ε4 (APOE ε4) allele, a robust AD risk factor, in the relationship between SCD and brain alterations is unknown. We examined whether APOE genotype modulates the association of SCD with brain measures in individuals at high AD risk. Methods Middle-aged adults with parental history of AD dementia underwent magnetic resonance imaging (MRI) and the Memory Functioning Questionnaire. Regression analysis tested the extent to which SCD was associated with activation during an functional MRI (fMRI) working-memory task, and white-matter microstructure. APOE ε4 genotype was tested as a moderator. Results Among APOE ε4 carriers, but not among non-carriers, SCD was associated with higher activation in the anterior cingulate (p = 0.003), inferior, middle, and superior frontal cortices (p = 0.041, p = 0.048, p = 0.037, respectively); and with lower fractional anisotropy in the uncinate fasciculus (p = 0.002), adjusting for age, sex, and education. Conclusion In middle aged, cognitively normal individuals at high AD risk, higher SCD was associated with greater brain alterations possibly reflecting incipient AD pathology. When accompanied by a family history of AD and an APOE ε4 allele, SCD may have important clinical value, allowing a window for early intervention and for participants' stratification in AD prevention clinical trials.
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Affiliation(s)
- Liat Ben-Ami
- Division of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel,The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Ramit Ravona-Springer
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel,Memory Clinic, Sheba Medical Center, Ramat Gan, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galia Tsarfaty
- Division of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Reut Raizman
- Division of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
| | - Aleeza Shumacher
- Division of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
| | - Inbal Sharvit-Ginon
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel,Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Lior Greenbaum
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Ramat Gan, Israel
| | - Barbara B. Bendlin
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
| | - Eitan Okun
- The Leslie and Susan Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel,The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel,The Paul Feder Laboratory on Alzheimer’s Disease Research, Bar-Ilan University, Ramat Gan, Israel
| | - Anthony Heymann
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,Maccabi Healthcare Services, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel,The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel,*Correspondence: Abigail Livny,
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20
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Rajczyk JI, Ferketich A, Wing JJ. Relation Between Smoking Status and Subjective Cognitive Decline in Middle Age and Older Adults: A Cross-Sectional Analysis of 2019 Behavioral Risk Factor Surveillance System Data. J Alzheimers Dis 2023; 91:215-223. [PMID: 36373317 DOI: 10.3233/jad-220501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Smoking status may influence subjective cognitive decline (SCD); however, few studies have evaluated this association. OBJECTIVE To assess whether smoking status is associated with SCD among middle age and older adults, and to determine if this association is modified by sex at birth. METHODS A cross-sectional analysis was conducted using data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) survey to analyze the relationship between SCD and smoking status (current, recent former, and remote former). Eligible respondents included participants 45 years of age or older who responded to the SCD and tobacco questions of interest. Survey-weighted Poisson regression models were employed to estimate the crude and adjusted prevalence ratios (cPR/aPR) and corresponding 95% confidence intervals (CI) of the association between smoking status and SCD. A Wald test was computed to determine the significance of the interaction term between smoking status and sex (α= 0.05). RESULTS There were 136,018 eligible respondents, of which approximately 10% had SCD. There was a graded association between smoking and SCD, with the greatest prevalence of SCD among current smokers (aPR = 1.87; CI: 1.54, 2.28), followed by recent former smokers (aPR = 1.47; 95% CI: 1.02, 2.12), and remote former smokers (aPR = 1.11; 95% CI: 0.93, 1.33) each compared to never smokers. There was no evidence of effect modification by sex (p interaction = 0.73). CONCLUSION The consistency of smoking as a risk factor for objective and subjective cognitive decline supports the need for future studies to further the evidence on whether changes to smoking status impacts cognition in middle age.
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Affiliation(s)
- Jenna I Rajczyk
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Amy Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Jeffrey J Wing
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
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21
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Königsberg A, Belau MH, Ascone L, Gallinat J, Kühn S, Jensen M, Gerloff C, Cheng B, Thomalla G. Subjective Cognitive Decline Is Associated with Health-Related Quality of Life in the Middle-Aged to Elderly Population. J Alzheimers Dis 2023; 91:427-436. [PMID: 36442192 DOI: 10.3233/jad-220659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is considered to be a preliminary stage of dementia, and its prevalence is increasing with age. OBJECTIVE We aimed to study the association of SCD with health-related quality of life (HRQoL) in a large population-based sample. METHODS We analyzed data of the first 10,000 participants from the Hamburg City Health Study in Germany, a single center prospective cohort study, aged between 45 and 74 years that scored higher than 25 points in the Mini-Mental State Examination and had no known pre-existing dementia. HRQoL was assessed by the EQ-5D-5 L index, as well as the mental (MCS) and physical component summary (PCS) score of the Short Form-8. We computed linear regression analyses with 99% bias-corrected and accelerated (BCa) confidence intervals (CI) from 10,000 bootstrap samples to investigate the association between SCD and different indicators of HRQoL, while controlling for depression (PHQ-9), age, sex, and education as potential confounders. RESULTS Of 7,799 eligible participants (mean (SD) age 62.01 (8.41) years, 51.1% female), 3,708 (47.5%) reported SCD. Participants with SCD were older (62.7 versus 61.4 years) and more frequently female (54.2% versus 48.2%). SCD was independently associated with a lower EQ-5D-5 L index (β=-0.01, 99% BCa CI = [-0.020, -0.003], p < 0.001) and PCS (β=-1.00, 99% BCa CI = [-1.48, -0.51], p < 0.001) but not with MCS score. CONCLUSION In a population of middle-aged to elderly participants, there is a significant negative association between SCD and HRQoL across different instruments of HRQoL measurement independent of depression, demographics, and education.
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Affiliation(s)
- Alina Königsberg
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias H Belau
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Leonie Ascone
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Hamburg, Germany
| | - Jürgen Gallinat
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Hamburg, Germany
| | - Simone Kühn
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Hamburg, Germany
| | - Märit Jensen
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Bastian Cheng
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Götz Thomalla
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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22
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Solovieva EY, Vorob'eva OV, Fateeva VV, Skipetrova LA. [Imaging of brain activity using fMRI in a patient with subjective cognitive decline]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:125-129. [PMID: 37084377 DOI: 10.17116/jnevro2023123041125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
In clinical practice, subjective cognitive decline (SCD) is often difficult to diagnose because it is not detected by standard neuropsychological and cognitive tests.The described clinical case is presented to demonstrate the difficulties of diagnosis and treatment choice in a patient with SCD. fMRI might be considered as an instrumental method to analyze the functional relationship between the activity of brain structures and cerebral circulation in patients with SCD. Patient clinical and neuropsychological data with a detailed description of fMRI with a cognitive paradigm are presented. The article is focused on the early diagnosis of SCD and the prognostic assessment of the transition of SCD to dementia.
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Affiliation(s)
- E Yu Solovieva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - O V Vorob'eva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V V Fateeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- OOO «NPF «MATERIA MEDICA HOLDING», Moscow, Russia
| | - L A Skipetrova
- Center for Speech Pathology and Neurorehabilitation, Moscow, Russia
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23
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Maffoni M, Pierobon A, Fundarò C. MASCoD-Multidimensional Assessment of Subjective Cognitive Decline. Front Psychol 2022; 13:921062. [PMID: 36533024 PMCID: PMC9748696 DOI: 10.3389/fpsyg.2022.921062] [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: 04/15/2022] [Accepted: 05/30/2022] [Indexed: 09/19/2023] Open
Abstract
Subjective cognitive decline (SCD) is a subclinical cognitive impairment that is complained by the individual without being objectively supported at clinical, diagnostic, and neuropsychological levels. It can negatively impact on patient's frailty and quality of life, as well as on the caregiver's burden. Moreover, it can be prodromal to Mild Cognitive Impairment or dementia. Although the clinical manifestations of SCD can differ along with several cognitive domains, to date there are only screening tools to investigate subjective memory complaints. Thus, the first aim of this paper is to propose a preliminary English and Italian version of a new screening tool called MASCoD (Multidimensional Assessment of Subjective Cognitive Decline); the second aim is to propose its preliminary adoption on a pilot sample. This schedule is a brief test derived from the review of the literature and the clinical experience provided by an experts panelist. From pilot tests, it seems promising as it can help the professional to make differential diagnosis and to predict the risk of developing severe cognitive impairment over time, developing a personalized care path. This screening tool is brief, easily embeddable in usual clinical assessment, and administrable by different professionals. Furthermore, following validation, it will allow to collect manifold cognitive manifestations of SCD, addressing the shortage of previous validated instruments globally assessing cognition affected by this condition.
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Affiliation(s)
- Marina Maffoni
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
| | - Antonia Pierobon
- Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
| | - Cira Fundarò
- Neurophysiopatology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Montescano Institute, Montescano, Italy
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24
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Verghese JP, Terry A, de Natale ER, Politis M. Research Evidence of the Role of the Glymphatic System and Its Potential Pharmacological Modulation in Neurodegenerative Diseases. J Clin Med 2022; 11:jcm11236964. [PMID: 36498538 PMCID: PMC9735716 DOI: 10.3390/jcm11236964] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/07/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The glymphatic system is a unique pathway that utilises end-feet Aquaporin 4 (AQP4) channels within perivascular astrocytes, which is believed to cause cerebrospinal fluid (CSF) inflow into perivascular space (PVS), providing nutrients and waste disposal of the brain parenchyma. It is theorised that the bulk flow of CSF within the PVS removes waste products, soluble proteins, and products of metabolic activity, such as amyloid-β (Aβ). In the experimental model, the glymphatic system is selectively active during slow-wave sleep, and its activity is affected by both sleep dysfunction and deprivation. Dysfunction of the glymphatic system has been proposed as a potential key driver of neurodegeneration. This hypothesis is indirectly supported by the close relationship between neurodegenerative diseases and sleep alterations, frequently occurring years before the clinical diagnosis. Therefore, a detailed characterisation of the function of the glymphatic system in human physiology and disease would shed light on its early stage pathophysiology. The study of the glymphatic system is also critical to identifying means for its pharmacological modulation, which may have the potential for disease modification. This review will critically outline the primary evidence from literature about the dysfunction of the glymphatic system in neurodegeneration and discuss the rationale and current knowledge about pharmacological modulation of the glymphatic system in the animal model and its potential clinical applications in human clinical trials.
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25
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Zhao JL, Cross N, Yao CW, Carrier J, Postuma RB, Gosselin N, Kakinami L, Dang-Vu TT. Insomnia disorder increases the risk of subjective memory decline in middle-aged and older adults: a longitudinal analysis of the Canadian Longitudinal Study on Aging. Sleep 2022; 45:zsac176. [PMID: 35877203 PMCID: PMC9644124 DOI: 10.1093/sleep/zsac176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/13/2022] [Indexed: 07/27/2023] Open
Abstract
STUDY OBJECTIVES To examine the longitudinal association between probable insomnia status and both subjective and objective memory decline in middle-aged and older adults. METHODS 26 363 participants, ≥45 years, completed baseline and follow-up (3 years after baseline) self-reported evaluations of sleep and memory, and neuropsychological testing in the following cognitive domains: memory, executive functions, and psychomotor speed. Participants were categorized as having probable insomnia disorder (PID), insomnia symptoms only (ISO), or no insomnia symptoms (NIS), based on sleep questionnaires. Participants were further grouped based on their sleep change over time. Prospective odds of self-reported memory worsening were assessed using logistic regression, and associations between insomnia and cognitive performance were assessed via linear mixed-effects modeling, adjusted for demographic, lifestyle, and medical factors. RESULTS An increased odds (OR 1.70; 95% CI 1.29-2.26) of self-reported memory worsening was observed for NIS participants at baseline who developed PID at follow-up compared to those who developed ISO or remained NIS. Additionally, participants whose sleep worsened from baseline to follow-up (i.e. transitioned from NIS to ISO, ISO to PID, or NIS to PID) displayed increased odds (OR 1.22; 95% CI 1.10-1.34) of subjective memory worsening at follow-up compared to those who remained insomnia-free or improved their sleep. There were no significant associations between the development of PID or worsening sleep and performance on neuropsychological tests. CONCLUSIONS These findings of an increased odds for subjective memory decline in middle-aged and older adults with insomnia disorder suggest insomnia may be an important target for early interventions addressing age-related cognitive decline.
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Affiliation(s)
| | - Nathan Cross
- Corresponding author. Nathan Cross and Thien Thanh Dang-Vu, Center for Studies in Behavioral Neurobiology and PERFORM Center, Concordia University, 7141 Sherbrooke St. West, SP 165.30, Montreal, QC, Canada. ;
| | - Chun W Yao
- Canadian Sleep and Circadian Network, Montreal, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
- Research Institute of McGill University Health Center, Montreal, Canada
| | - Julie Carrier
- Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l’Ile-de-Montréal, Montreal, Canada
- Canadian Sleep and Circadian Network, Montreal, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montreal, CIUSSS du Nord-de-l’Ile-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Ronald B Postuma
- Canadian Sleep and Circadian Network, Montreal, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montreal, CIUSSS du Nord-de-l’Ile-de-Montréal, Montreal, Canada
- Department of Neurology and Neurosurgery, McGill University—Montreal General Hospital, Montreal, Canada
| | - Nadia Gosselin
- Canadian Sleep and Circadian Network, Montreal, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montreal, CIUSSS du Nord-de-l’Ile-de-Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Lisa Kakinami
- PERFORM Centre, Concordia University, Montreal, Canada
- Department of Mathematics and Statistics, Concordia University, Montreal, Canada
| | - Thien Thanh Dang-Vu
- Corresponding author. Nathan Cross and Thien Thanh Dang-Vu, Center for Studies in Behavioral Neurobiology and PERFORM Center, Concordia University, 7141 Sherbrooke St. West, SP 165.30, Montreal, QC, Canada. ;
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26
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Samson AD, Shen K, Grady CL, McIntosh AR. Exploration of salient risk factors involved in mild cognitive impairment. Eur J Neurosci 2022; 56:5368-5383. [PMID: 35388543 DOI: 10.1111/ejn.15665] [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: 10/31/2021] [Revised: 03/14/2022] [Accepted: 03/31/2022] [Indexed: 12/14/2022]
Abstract
Mild cognitive impairment (MCI) is a prevalent and complex condition among older adults that often progresses into Alzheimer's disease (AD). Although MCI affects individuals differently, there are specific indicators of risk commonly associated with the development of MCI. The present study explored the prevalence of seven established MCI risk categories within a large sample of older adults with and without MCI. We explored trends across the different diagnostic groups and extracted the most salient risk factors related to MCI using partial least squares. Neuropsychological risk categories showed the largest differences across groups, with the cognitively unimpaired groups outperforming the MCI groups on all measures. Apolipoprotein E4 (ApoE4) carriers were significantly more common among the more severe MCI group, whereas ApoE4 non-carriers were more common in the healthy controls. Participants with subjective and objective cognitive impairment were trending towards AD-like cerebral spinal fluid (CSF) biomarker levels. Increased age, being male and having fewer years of education were identified as important risk factors of MCI. Higher CSF tau levels were correlated with ApoE4 carrier status, age and a decrease in the ability to carry out daily activities across all diagnostic groups. Amyloid beta1-42 CSF concentration was positively correlated with cognitive and memory performance and non-ApoE4 carrier status regardless of diagnostic status. Unlike previous research, poor cardiovascular health or being female had no relation to MCI. Altogether, the results highlighted risk factors that were specific to persons with MCI, findings that will inform future research in healthy aging, MCI and AD.
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Affiliation(s)
- Alexandria D Samson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Kelly Shen
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Institute for Neuroscience and Neurotechnology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Cheryl L Grady
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anthony R McIntosh
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Institute for Neuroscience and Neurotechnology, Simon Fraser University, Burnaby, British Columbia, Canada.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
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27
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Fathi M, Vakili K, Yaghoobpoor S, Tavasol A, Jazi K, Hajibeygi R, Shool S, Sodeifian F, Klegeris A, McElhinney A, Tavirani MR, Sayehmiri F. Dynamic changes in metabolites of the kynurenine pathway in Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease: A systematic Review and meta-analysis. Front Immunol 2022; 13:997240. [PMID: 36263032 PMCID: PMC9574226 DOI: 10.3389/fimmu.2022.997240] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Tryptophan (TRP) is an essential amino acid that must be provided in the diet. The kynurenine pathway (KP) is the main route of TRP catabolism into nicotinamide adenosine dinucleotide (NAD+), and metabolites of this pathway may have protective or degenerative effects on the nervous system. Thus, the KP may be involved in neurodegenerative diseases. Objectives The purpose of this systematic review and meta-analysis is to assess the changes in KP metabolites such as TRP, kynurenine (KYN), kynurenic acid (KYNA), Anthranilic acid (AA), 3-hydroxykynurenine (3-HK), 5-Hydroxyindoleacetic acid (5-HIAA), and 3-Hydroxyanthranilic acid (3-HANA) in Alzheimer’s disease (AD), Parkinson’s disease (PD), and Huntington’s disease (HD) patients compared to the control group. Methods We conducted a literature search using PubMed/Medline, Scopus, Google Scholar, Web of Science, and EMBASE electronic databases to find articles published up to 2022. Studies measuring TRP, KYN, KYNA, AA, 3-HK, 5-HIAA, 3-HANA in AD, PD, or HD patients and controls were identified. Standardized mean differences (SMDs) were used to determine the differences in the levels of the KP metabolites between the two groups. Results A total of 30 studies compromising 689 patients and 774 controls were included in our meta-analysis. Our results showed that the blood levels of TRP was significantly lower in the AD (SMD=-0.68, 95% CI=-0.97 to -0.40, p=0.000, I2 = 41.8%, k=8, n=382), PD (SMD=-0.77, 95% CI=-1.24 to -0.30, p=0.001, I2 = 74.9%, k=4, n=352), and HD (SMD=-0.90, 95% CI=-1.71 to -0.10, p=0.028, I2 = 91.0%, k=5, n=369) patients compared to the controls. Moreover, the CSF levels of 3-HK in AD patients (p=0.020) and the blood levels of KYN in HD patients (p=0.020) were lower compared with controls. Conclusion Overall, the findings of this meta-analysis support the hypothesis that the alterations in the KP may be involved in the pathogenesis of AD, PD, and HD. However, additional research is needed to show whether other KP metabolites also vary in AD, PD, and HD patients. So, the metabolites of KP can be used for better diagnosing these diseases.
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Affiliation(s)
- Mobina Fathi
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimia Vakili
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Yaghoobpoor
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arian Tavasol
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimia Jazi
- Student Research Committee, Faculty of Medicine, Medical University of Qom, Qom, Iran
| | - Ramtin Hajibeygi
- Department of Neurology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sina Shool
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sodeifian
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Andis Klegeris
- Department of Biology, Faculty of Science, University of British Columbia Okanagan Campus, Kelowna, BC, Canada
| | - Alyssa McElhinney
- Department of Biology, Faculty of Science, University of British Columbia Okanagan Campus, Kelowna, BC, Canada
| | - Mostafa Rezaei Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Mostafa Rezaei Tavirani, ; Fatemeh Sayehmiri,
| | - Fatemeh Sayehmiri
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Mostafa Rezaei Tavirani, ; Fatemeh Sayehmiri,
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28
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Ayers E, Wang C, Verghese J. Validation of a "subjective motoric cognitive risk syndrome" screening tool for motoric cognitive risk syndrome-A prospective cohort study. Eur J Neurol 2022; 29:2925-2933. [PMID: 35748730 PMCID: PMC9875832 DOI: 10.1111/ene.15476] [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: 04/07/2022] [Revised: 06/02/2022] [Accepted: 06/19/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND PURPOSE Motoric cognitive risk syndrome (MCR) is a gait-based pre-dementia syndrome associated with risk of dementia. Ascertaining subjective cognitive and motoric complaints may facilitate early and remote identification of individuals with MCR as they are reported to precede and predict objective cognitive and motoric impairments in aging. METHODS The validity of five subjective motoric complaint (SMC) questions and 10 subjective cognitive complaint (SCC) questions was examined for discriminating MCR in 538 non-demented community-dwelling adults. Backward logistic regression was used to identify questions to develop a weighted score to define subjective MCR (MCR-S). Receiver operating characteristic analysis was applied to determine the discriminative ability of MCR-S for the objective MCR (MCR-O) definition based on SCCs and objectively measured gait. Cox proportional hazard models adjusted for potential confounders were used to examine the predictive validity of MCR-S for incident dementia. RESULTS Five subjective complaint questions (three SCC and two SMC) were associated with MCR-O. They were combined to define an MCR-S score (range 0-7) which yielded an area under the curve of 0.89 for discriminating MCR-O from receiver operating characteristic analysis. An optimal cut-score of 2 on the MCR-S score was determined to have good sensitivity (84%) and specificity (82%) for MCR-O. Over a median follow-up of 2.5 years, 29 participants developed dementia. Both MCR-S (adjusted hazard ratio 2.39) and MCR-O at baseline (adjusted hazard ratio 3.16) predicted risk of incident dementia. CONCLUSIONS Subjective MCR had high concordance with MCR-O and can provide a remote screening assessment for MCR-O, which can identify those at high risk for dementia.
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Affiliation(s)
- Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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29
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Akinci M, Sánchez-Benavides G, Brugulat-Serrat A, Peña-Gómez C, Palpatzis E, Shekari M, Deulofeu C, Fuentes-Julian S, Salvadó G, González-de-Echávarri JM, Suárez-Calvet M, Minguillón C, Fauria K, Molinuevo JL, Gispert JD, Grau-Rivera O, Arenaza-Urquijo EM, Beteta A, Cacciaglia R, Cañas A, Cumplido I, Dominguez R, Emilio M, Falcon C, Hernandez L, Huesa G, Huguet J, Marne P, Menchón T, Operto G, Polo A, Rodríguez-Fernández B, Pradas S, Sadeghi I, Soteras A, Stankeviciute L, Vilanova M, Vilor-Tejedor N. Subjective cognitive decline and anxious/depressive symptoms during the COVID-19 pandemic: what is the role of stress perception, stress resilience, and β-amyloid? Alzheimers Res Ther 2022; 14:126. [PMID: 36068641 PMCID: PMC9446623 DOI: 10.1186/s13195-022-01068-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/28/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The COVID-19 pandemic may worsen the mental health of people reporting subjective cognitive decline (SCD) and therefore their clinical prognosis. We aimed to investigate the association between the intensity of SCD and anxious/depressive symptoms during confinement and the underlying mechanisms.
Methods
Two hundred fifty cognitively unimpaired participants completed the Hospital Anxiety and Depression Scale (HADS) and SCD-Questionnaire (SCD-Q) and underwent amyloid-β positron emission tomography imaging with [18F] flutemetamol (N = 205) on average 2.4 (± 0.8) years before the COVID-19 confinement. During the confinement, participants completed the HADS, Perceived Stress Scale (PSS), Brief Resilience Scale (BRS), and an ad hoc questionnaire on worries (access to primary products, self-protection materials, economic situation) and lifestyle changes (sleep duration, sleep quality, eating habits). We investigated stress-related measurements, worries, and lifestyle changes in relation to SCD. We then conducted an analysis of covariance to investigate the association of SCD-Q with HADS scores during the confinement while controlling for pre-confinement anxiety/depression scores and demographics. Furthermore, we introduced amyloid-β positivity, PSS, and BRS in the models and performed mediation analyses to explore the mechanisms explaining the association between SCD and anxiety/depression.
Results
In the whole sample, the average SCD-Q score was 4.1 (± 4.4); 70 (28%) participants were classified as SCD, and 26 (12.7%) were amyloid-β-positive. During the confinement, participants reporting SCD showed higher PSS (p = 0.035) but not BRS scores (p = 0.65) than those that did not report SCD. No differences in worries or lifestyle changes were observed. Higher SCD-Q scores showed an association with greater anxiety/depression scores irrespective of pre-confinement anxiety/depression levels (p = 0.002). This association was not significant after introducing amyloid-β positivity and stress-related variables in the model (p = 0.069). Amyloid-β positivity and PSS were associated with greater HADS irrespective of pre-confinement anxiety/depression scores (p = 0.023; p < 0.001). The association of SCD-Q with HADS was mediated by PSS (p = 0.01).
Conclusions
Higher intensity of SCD, amyloid-β positivity, and stress perception showed independent associations with anxious/depressive symptoms during the COVID-19 confinement irrespective of pre-confinement anxiety/depression levels. The association of SCD intensity with anxiety/depression was mediated by stress perception, suggesting stress regulation as a potential intervention to reduce affective symptomatology in the SCD population in the face of stressors.
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Smid J, Studart-Neto A, César-Freitas KG, Dourado MCN, Kochhann R, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Resende EDPF, Vale FAC. Subjective cognitive decline, mild cognitive impairment, and dementia - syndromic approach: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s101en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
ABSTRACT This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.
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Affiliation(s)
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Smid J, Studart-Neto A, César-Freitas KG, Dourado MCN, Kochhann R, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Caramelli P, Bertolucci PHF, Chaves MLF, Brucki SMD, Nitrini R, Resende EDPF, Vale FAC. Declínio cognitivo subjetivo, comprometimento cognitivo leve e demência - diagnóstico sindrômico: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:1-24. [DOI: 10.1590/1980-5764-dn-2022-s101pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/03/2022] [Accepted: 04/27/2022] [Indexed: 12/15/2022] Open
Abstract
RESUMO Este consenso realizado pela Academia Brasileira de Neurologia (ABN) abordará de maneira prática como avaliar pacientes com queixas cognitivas e como realizar o diagnóstico clínico e etiológico das três síndromes clínicas associadas aos estágios de declínio cognitivo: declínio cognitivo subjetivo (DCS), comprometimento cognitivo leve (CCL) e demência. O diagnóstico de DCS é discutido pela primeira vez em consenso da ABN e as atualizações para o diagnóstico de CCL e demência são abordadas, bem como a recomendação para o uso de testes cognitivos apropriados, investigação etiológica pertinente e cuidados aos pacientes com declínio cognitivo nos diferentes níveis de atenção do Sistema Único de Saúde. Foi realizada pesquisa dos principais instrumentos de avaliação utilizados em nosso meio e na América Latina.
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Affiliation(s)
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Senft Miller A, Nop O, Slavich GM, Dumas JA. Lifetime stress exposure, cognition, and psychiatric wellbeing in women. Aging Ment Health 2022; 26:1765-1770. [PMID: 34355591 PMCID: PMC8818064 DOI: 10.1080/13607863.2021.1958144] [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] [Indexed: 12/19/2022]
Abstract
Objectives:Although life stress has been associated with worse cognitive and psychiatric functioning, few studies on this topic have examined these associations in older adults and no studies to date have assessed lifetime stress exposure in this context.Method:To address this important issue, we investigated associations between lifetime stress exposure, cognition, and psychiatric wellbeing in 44 women aged 60 and older who completed a comprehensive lifetime stress exposure inventory, two memory tasks, and a complete psychiatric assessment.Results:As hypothesized, greater acute and chronic lifetime stress exposure were both related to poorer psychiatric functioning and more somatic health complaints. Greater lifetime stress exposure was also associated with poorer subjective cognition as indicated by memory and thought problems but not objective indices of memory function.Conclusion:Screening for high life stress exposure may therefore help identify older women at increased risk of experiencing negative psychiatric and cognitive outcomes.
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Affiliation(s)
- Anna Senft Miller
- Clinical neuroscience Research Unit, Department of Psychiatry, University of Vermont, Burlington, Vt, USA
| | - Olivia Nop
- Clinical neuroscience Research Unit, Department of Psychiatry, University of Vermont, Burlington, Vt, USA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, los Angeles, CA, USA
| | - Julie A. Dumas
- Clinical neuroscience Research Unit, Department of Psychiatry, University of Vermont, Burlington, Vt, USA
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Merz ZC, Lace JW. Clinical utility of the Saint Louis University Mental Status Examination (SLUMS) in a mixed neurological sample: Proposed revised cutoff scores for normal cognition, mild cognitive impairment, and dementia. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-8. [PMID: 35930237 DOI: 10.1080/23279095.2022.2106572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University Mental Status examination (SLUMS) at identifying examinees with normal cognition, mild cognitive impairment, or dementia syndrome using the criterion of a comprehensive neuropsychological assessment. Two hundred sixty-three examinees (M age = 67.84 ± 12.72; 59.3% female; 81.4% white) were referred for comprehensive neuropsychological evaluation at a private, Mid-Atlantic medical center. Using original cutoff scores, the SLUMS correctly classified just over half (55.1%) of examinees. Classification statistics suggested modified cutoff scores for mild cognitive impairment (≤24) and dementia (≤17) with strong discriminability between cognitive status groups (AUCs ranged from .834 to .986). These proposed revised cutoff scores improved overall concordance between SLUMS and diagnostic conclusions from comprehensive clinical neuropsychological testing, correctly classifying nearly two-thirds of examinees (65.4%). The SLUMS and its revised cutoff scores appear to have clinical utility for cognitive screening in primary care and neurological settings to inform treatment plans and appropriate referrals for comprehensive neuropsychological assessment.
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Affiliation(s)
- Zachary C Merz
- LeBauer Department of Neurology, Moses H. Cone Memorial Hospital, Greensboro, NC, USA
| | - John W Lace
- Section of Neuropsychology, Cleveland Clinic, Neurological Institute, Cleveland, OH, USA
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From Subjective Cognitive Decline to Mild Cognitive Impairment to Dementia: Clinical and Capacity Assessment Considerations. PSYCHOLOGICAL INJURY & LAW 2022. [DOI: 10.1007/s12207-022-09456-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thomas EG, Rhodius-Meester H, Exalto L, Peters SAE, van Bloemendaal L, Ponds R, Muller M. Sex-Specific Associations of Diabetes With Brain Structure and Function in a Geriatric Population. Front Aging Neurosci 2022; 14:885787. [PMID: 35837485 PMCID: PMC9273850 DOI: 10.3389/fnagi.2022.885787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/20/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Globally, women with dementia have a higher disease burden than men with dementia. In addition, women with diabetes especially are at higher risk for cognitive impairment and dementia compared to men with diabetes. Differences in the influence of diabetes on the cerebral vasculature and brain structure may contribute to these sex-specific differences. We examined sex-specific patterns in the relationship between diabetes and brain structure, as well as diabetes and cognitive function. Methods In total, 893 patients [age 79 ± 6.6 years, 446 (50%) women] from the Amsterdam Ageing Cohort with available data on brain structures (assessed by an MRI or CT scan) and cognitive function were included. All patients underwent a thorough standardized clinical and neuropsychological assessment (including tests on memory, executive functioning, processing speed, language). Brain structure abnormalities were quantified using visual scales. Results Cross-sectional multivariable regression analyses showed that diabetes was associated with increased incidence of cerebral lacunes and brain atrophy in women (OR 2.18 (1.00–4.72) but not in men. Furthermore, diabetes was associated with decreased executive function, processing speed and language in women [B −0.07 (0.00–0.13), −0.06 (0.02–0.10) and −0.07 (0.01–0.12) resp.] but not in men. Conclusions Diabetes is related to increased risk of having lacunes, brain atrophy and impaired cognitive function in women but not in men. Further research is required to understand the time trajectory leading up to these changes and to understand the mechanisms behind them in order to improve preventive health care for both sexes.
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Affiliation(s)
- Elias G. Thomas
- Department of Internal Medicine, Geriatrics Section, Amsterdam Cardiovascular Science, Amsterdam University Medical Centre, Amsterdam UMC, Amsterdam, Netherlands
- Department of Internal Medicine, Amsterdam Public Health Institute, Amsterdam UMC, Amsterdam, Netherlands
- *Correspondence: Elias G. Thomas
| | - Hanneke Rhodius-Meester
- Department of Internal Medicine, Geriatrics Section, Amsterdam Cardiovascular Science, Amsterdam University Medical Centre, Amsterdam UMC, Amsterdam, Netherlands
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, VU University Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Lieza Exalto
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sanne A. E. Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Liselotte van Bloemendaal
- Department of Internal Medicine, Geriatrics Section, Amsterdam Cardiovascular Science, Amsterdam University Medical Centre, Amsterdam UMC, Amsterdam, Netherlands
| | - Rudolf Ponds
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Majon Muller
- Department of Internal Medicine, Geriatrics Section, Amsterdam Cardiovascular Science, Amsterdam University Medical Centre, Amsterdam UMC, Amsterdam, Netherlands
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Smith L, Oh H, Jacob L, López-Sánchez GF, Veronese N, Soysal P, Shin JI, Schuch F, Tully MA, Butler L, Barnett Y, Koyanagi A. Sleep problems and subjective cognitive complaints among middle-aged and older adults in 45 low- and middle-income countries. Aging Clin Exp Res 2022; 34:1285-1293. [PMID: 34985716 DOI: 10.1007/s40520-021-02052-1] [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: 09/21/2021] [Accepted: 12/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Currently, a small body of evidence suggests that sleep problems are positively associated with subjective cognitive complaints (SCC). However, no studies on this topic exist from low- and middle-income countries (LMICs). Thus, we investigated the association between sleep problems and SCC in a large sample of middle-age and older adults from 45 LMICs. METHODS Cross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. Sleep problems (such as difficulties falling asleep, waking up frequently during the night or waking up too early in the morning) in the last 30 days were self-reported. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Multivariable linear regression was conducted to explore the association between sleep problems (exposure) and SCC (outcome). RESULTS Data on 60,228 adults aged ≥ 50 years were analyzed [mean (SD) age 61.4 (9.9) years; 53.9% females]. After adjustment for potential confounders, compared to those without sleep problems, the mean SCC score for the multivariable model was 13.32 (95% CI 12.01, 14.63), 19.46 (95% CI 17.95, 20.98), 24.17 (95% CI 22.02, 26.33), and 31.39 (95% CI 28.13, 34.65) points higher for mild, moderate, severe, and extreme sleep problems, respectively. Similar results were found for analyses stratified by age and country-income level. CONCLUSION Sleep problems were positively associated in a dose-response manner with SCC among middle-aged and older adults in multiple LMICs. Addressing sleep problems may aid in the prevention of SCC and ultimately dementia, pending future longitudinal research.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - Guillermo F López-Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, 30100, Espinardo, Murcia, Spain.
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), Fatih, 34093, İstanbul, Turkey
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey, BT37 0QB, Northern Ireland, UK
| | - Laurie Butler
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Yvonne Barnett
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
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Lequerica AH, Houston M, Chen MH, Arango-Lasprilla JC. Preliminary construct validity of a memory concerns scale derived from a PROMIS® item bank in a spanish-speaking sample. Neuropsychol Rehabil 2022:1-13. [PMID: 35362366 DOI: 10.1080/09602011.2022.2058965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined preliminary evidence of construct validity in a stand-alone memory concerns scale constructed from the Patient-Reported Outcomes Measurement Information System (PROMIS®) Cognitive Function item bank. A sample of 396 individuals, ages 18-75 (M = 33.7, SD = 12.7), from Spain and Latin America completed an online survey regarding lifetime exposure to factors associated with neurological compromise. The sample was 69.4% female. Respondents completed 8 items from the PROMIS® Cognitive Function item bank v1.0 dealing with memory concerns (MCS-8) along with the PROMIS® 8-item short form reflecting general cognitive concerns (CCS-8). The MCS-8 had high internal consistency reliability (Cronbach's alpha = 0.90), and represented a factor distinct from general cognitive concerns items on the CCS-8 in confirmatory factor analysis. Analysis of covariance controlling for sex, age, and education, showed that individuals endorsing history of exposure to sources of neurological compromise scored significantly lower T-scores on the MCS-8 than those who did not report any such history, F(1,390) = 6.4, p = 0.012. Older age was significantly associated with greater memory concerns, a relationship with age not observed with the CCS-8. As a stand-alone self-report measure, the MCS-8 appears to measure a construct distinct from general cognitive concerns that may be of interest for further research in clinical populations.
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Affiliation(s)
- Anthony H Lequerica
- Kessler Foundation, East Hanover, NJ, USA.,Rutgers - New Jersey Medical School, Newark, NJ, USA
| | | | - Michelle H Chen
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, NJ, USA.,Robert Wood Johnson Medical School, Rutgers University, NJ, USA
| | - Juan Carlos Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute. Barakaldo, Bizkaia, Spain.,IKERBASQUE. Basque Foundation for Science, Bilbao, Spain
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Liu Y, Jiang D. Multimorbidity Patterns in US Adults with Subjective Cognitive Decline and Their Relationship with Functional Difficulties. J Aging Health 2022; 34:929-938. [PMID: 35331040 PMCID: PMC9483692 DOI: 10.1177/08982643221080287] [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] [Indexed: 11/16/2022]
Abstract
Objectives This study identified different multimorbidity patterns among adults with subjective
cognitive decline (SCD) and examined their association with SCD-related functional
difficulties. Methods Data were obtained from the 2019 Behavioral Risk Factor Surveillance System. Latent
class analysis was applied to identify different patterns of chronic conditions.
Logistic regression was implemented to examine relationships between multimorbidity
patterns and risk of SCD-related functional difficulties. Results Five multimorbidity patterns were identified: severely impaired (14.6%),
respiratory/depression (18.2%), obesity/diabetes (18.6%), age-associated (22.3%), and
minimal chronic conditions group (26.3%). Compared with minimal chronic conditions
group, severely impaired group was most likely to report SCD-related functional
difficulties, followed by respiratory/depression and obesity/diabetes group. Discussions Individuals in the three multimorbidity groups had elevated risk of SCD-related
functional difficulties compared with minimal chronic conditions group. Characteristics
of the high-risk groups identified in this study may help in development and
implementation of interventions to prevent serious consequences of having multiple
chronic conditions.
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Affiliation(s)
- Yixiu Liu
- Department of Community Health Sciences, 8664University of Manitoba, Winnipeg, MB, Canada
| | - Depeng Jiang
- Department of Community Health Sciences, 8664University of Manitoba, Winnipeg, MB, Canada
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Dixon E, Anderson J, Lazar A. Understanding How Sensory Changes Experienced by Individuals with a Range of Age-Related Cognitive Changes can Effect Technology Use. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2022; 15. [DOI: 10.1145/3511906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Clinical researchers have identified sensory changes people with age-related cognitive changes, such as dementia and mild cognitive impairment, experience which are different from typical age-related sensory changes. Technology designers and researchers do not yet have an understanding of how these unique sensory changes affect technology use. This work begins to bridge the gap between the clinical knowledge of sensory changes and technology research and design through interviews with people with mild to moderate dementia, mild cognitive impairment, subjective cognitive decline, and healthcare professionals. This extended version of our ASSETS conference paper includes people with a range of age-related cognitive changes describing changes in vision, hearing, speech, dexterity, proprioception, and smell. We discuss each of these sensory changes and ways to leverage optimal modes of sensory interaction for accessible technology use with existing and emerging technologies. Finally, we discuss how accessible sensory stimulation may change across the spectrum of age-related cognitive changes.
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Affiliation(s)
- Emma Dixon
- University of Maryland, College Park, Maryland, USA
| | | | - Amanda Lazar
- University of Maryland, College Park, Maryland, USA
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Vintimilla R, Mathew E, Hall J, Johnson L, O'Bryant S. Subjective cognitive complaints and cardiovascular risk factors in older Mexican Americans: A cross-sectional study. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100126. [PMID: 36324397 PMCID: PMC9616272 DOI: 10.1016/j.cccb.2022.100126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/14/2022] [Accepted: 02/19/2022] [Indexed: 06/16/2023]
Abstract
Background Subjective cognitive complaints (SCC) are associated with higher risk of mild cognitive impairment (MCI) and dementia. Cardiovascular risk factors (CVRF) have been also associated with cognitive decline, MCI, and dementia. Few studies have examined the associated of CVRF and SCC. Methods Participants were cognitively normal Mexican Americans from the HABLE study. Participants were categorized as with and without SCC, and SCC was also measured as a continuous variable. CVRF diagnosis were ascertained during consensus review. Cognitive measures used were MMSE, Trails B, SEVLT, and digit span. Logistic regression and linear regression were used to asses the association of SCC with CVRF and cognitive scores. Results A total of 673 participants [mean age 63.3 (SD=7.71), 69.2% female] were included. SCC was present in 323 participants (47.99%). Dyslipidemia and depression were associated with SCC. Individuals with dyslipidemia had 1.72 times the odds (95% CI = 1.20 to 2.47) of SCC, and those with depression had 3.15 times the odds (95% CI = 2.16 to 4.59) of self-reporting SCC. Higher SCC scores, were significantly associated with MMSE (B = 0.07; SE = 0.03; p = 0.02), and SEVLT immediate and delayed (B= -0.03; SE = 0.00; p = 0.000 and B = -0.03; SE = 0.00; p = 0.000, respectively). Conclusions In a cognitively normal Mexican Americans sample of older adults, depression and dyslipidemia were correlated with self-reported SCC. A greater self-perception of cognitive decline correlated with lower scores on the MMSE and SEVLT.
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Affiliation(s)
- Raul Vintimilla
- University of North Texas Health Science Center – Institute for Translational Research, 855 Montgomery St, Fort Worth, Texas, 76107
| | - Ezek Mathew
- University of North Texas Health Science Center – Texas College of Osteopathic medicine, 3500 Camp Bowie Blvd, Fort Worth, Texas, 76107
| | - James Hall
- University of North Texas Health Science Center – Institute for Translational Research, 855 Montgomery St, Fort Worth, Texas, 76107
| | - Leigh Johnson
- University of North Texas Health Science Center – Institute for Translational Research, 855 Montgomery St, Fort Worth, Texas, 76107
| | - Sid O'Bryant
- University of North Texas Health Science Center – Institute for Translational Research, 855 Montgomery St, Fort Worth, Texas, 76107
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Cognitive screening in HTLV-1-infected people using a self-perceived memory score and auditory P300. J Neurovirol 2022; 28:123-132. [PMID: 35167053 DOI: 10.1007/s13365-021-01044-1] [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: 07/12/2021] [Revised: 11/21/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
The HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common neurological manifestation associated with human T-cell lymphotropic virus type-1 (HTLV-1) infection. Although cognitive impairment has been highlighted in the spectrum of HTLV-1 neurological manifestations, it may go unnoticed in those who do not spontaneously report it. We aimed at evaluating the applicability of a self-perceived memory score (SMS) and the cognitive event-related potential (P300) for early detection of cognitive impairment in HTLV-1-infected people. The SMS was measured by a 0-10 point numeric scale combined with a sad-happy face rating scale. The higher the number, the better was the SMS. The P300 was obtained through an oddball paradigm with a mental counting task. The participants were 15 (21.4%) individuals with HAM/TSP, 20 (28.6%) HTLV-1 asymptomatic carriers, and 35 (50%) seronegative controls. We found that SMS (p < 0.001) and P300 latency (p < 0.001) got progressively worse from the seronegative controls to the asymptomatic carriers and then to the HAM/TSP. The results that indicated cognitive impairment were SMS < 7.2 points and P300 latency > 369.0 ms. The HAM/TSP group showed the highest prevalence of altered P300 (80%) and SMS (87%). Interestingly, the asymptomatic group also presented significantly higher prevalence of altered SMS (60%) and P300 (35%) when compared to controls (< 10%). The frequency of cognitive impairment was 16 times higher in the HTLV-1 asymptomatic group and 69 times higher in the HAM/TSP group when compared to controls. The use of SMS in the medical consultation was a useful and easy-to-apply method to screen HTLV-1-infected subjects for everyday memory complaints.
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Brown MJ, Joseph C, James T, Haider MR, Zahnd WE, Cohen SA. Gender and Racial/Ethnic Disparities in Social Determinants of Health and Subjective Cognitive Decline: The Mediating Role of Depression. J Gerontol Nurs 2022; 48:13-22. [PMID: 35103521 PMCID: PMC9003396 DOI: 10.3928/00989134-20220110-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Social determinants of health (SDOH) may be associated with subjective cognitive decline (SCD), which is a precursor for Alzheimer's disease. The main aims of the current study were to examine the association between SDOH and SCD; to determine if there is an indirect pathway among SDOH, depression, and SCD; and to examine the related gender and racial/ethnic disparities. Cross-sectional data were obtained from the 2017 Behavioral Risk Factor Surveillance System Survey (N = 6,509; 2,530 men and 3,978 women aged ≥45 years). Path analyses (stratified by gender and race) were used to determine the relationship between a SDOH index, depression, and SCD. After controlling for gender, age, income, education, employment, and other health-related behaviors, SDOH were positively associated with SCD among the overall population, men, and White populations. SDOH were associated with depression, and depression was associated with SCD among men, women, and White and Black populations. After adjustment for confounders, the indirect pathway among SDOH, depression, and SCD was statistically significant for men (β = 0.035, p < 0.001), women (β = 0.040, p < 0.001), White populations (β = 0.034, p < 0.001), and Black populations (β = 0.036, p = 0.026). Gender and racial/ethnic disparities existed in the relationship among SDOH, depression, and SCD. Future research should assess alternative mediational pathways between SDOH and SCD. [Journal of Gerontological Nursing, 48(2), 13-22.].
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Affiliation(s)
- Monique J. Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina,South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina,Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Chantaezia Joseph
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Titilayo James
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Whitney E. Zahnd
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Steven A. Cohen
- Department of Health Studies, University of Rhode Island, Kingston, Rhode Island
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Setton R, Lockrow AW, Turner GR, Spreng RN. Troubled past: A critical psychometric assessment of the self-report Survey of Autobiographical Memory (SAM). Behav Res Methods 2022; 54:261-286. [PMID: 34159511 PMCID: PMC8692492 DOI: 10.3758/s13428-021-01604-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 12/24/2022]
Abstract
The Survey of Autobiographical Memory (SAM) was designed as an easy-to-administer measure of self-perceived autobiographical memory (AM) recollection capacity. We provide a comprehensive psychometric evaluation of the SAM in younger and older adults. First, we evaluated the reliability of the SAM as a measure of self-perceived recollective capacity. Next, we tested whether the SAM was a valid measure of episodic and autobiographical memory performance, as assessed with widely used performance-based measures. Finally, we investigated associations between the SAM, cognitive measures and self-reported assessments of psychological functioning. The SAM demonstrated reliability as a self-report measure of perceived recollective capacity. High internal consistency was observed across subscales, with the exception of SAM-semantic. Evidence for independence among the subscales was mixed: SAM-episodic and SAM-semantic items showed poor correspondence with respective subscales. Good correspondence was observed between the future and spatial items and their SAM subscales. The SAM showed limited associations with AM performance as measured by the Autobiographical Interview (AI), yet was broadly associated with self-reported AI event vividness. SAM scores were weakly associated with performance-based memory measures and were age-invariant, inconsistent with known age effects on declarative memory. Converging evidence indicated that SAM-episodic and SAM-semantic subscales are not independent and should not be interpreted as specific measures of episodic or semantic memory. The SAM was robustly associated with self-efficacy, suggesting an association with confidence in domain general self-report abilities. We urge caution in the use and interpretation of the SAM as a measure of AM, pending revision and further psychometric validation.
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Affiliation(s)
- Roni Setton
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University St., Montreal, QC, H3A 2B4, Canada
| | - Amber W Lockrow
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University St., Montreal, QC, H3A 2B4, Canada
| | - Gary R Turner
- Department of Psychology, York University, Toronto, ON, Canada
| | - R Nathan Spreng
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University St., Montreal, QC, H3A 2B4, Canada.
- McConnell Brain Imaging Centre, McGill University, Montreal, QC, Canada.
- Departments of Psychiatry and Psychology, McGill University, Montreal, QC, Canada.
- Douglas Mental Health University Institute, Montreal, QC, Canada.
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Brown MJ, Hill NL, Haider MR. Age and gender disparities in depression and subjective cognitive decline-related outcomes. Aging Ment Health 2022; 26:48-55. [PMID: 33325263 PMCID: PMC8206234 DOI: 10.1080/13607863.2020.1861214] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Determine the association between depression and SCD-related outcomes by age and gender. METHODS Using 2018 Behavioral Risk Factor Surveillance System survey data, crude and multivariable logistic regression models were used to determine the associations between depression and SCD-related outcomes by age and gender. RESULTS Among respondents 45 to 69, depression was associated with SCD [adjusted OR (aOR): 4.36; 95% CI: 3.24-5.86]; needing assistance with activities due to confusion/memory loss (aOR: 2.38; 95% CI: 1.26 - 4.51); needing help with activities and the help is not available (aOR: 4.46; 95% CI: 1.31 - 15.2); and having discussed confusion/memory loss with a health care professional (aOR: 1.87; 95% CI: 1.09 - 3.23). However, among respondents 70 and older, depression was associated with SCD (aOR): 3.52; 95% CI: 2.06-6.02); needing help with activities and the help is not available (aOR: 0.09; 95% CI: 0.01-0.56); confusion/memory loss interfering with work/social activities (aOR: 2.44; 95% CI: 1.03-5.79); and having discussed confusion/memory loss with a health care professional (aOR): 2.99; 95% CI: 1.20-7.40). Depression was positively associated with SCD among men (aOR): 3.68; 95% CI: 2.52-5.38) and women (aOR): 4.76; 95% CI: 3.29-6.87; and was positively associated with all SCD-related outcomes among men except for confusion/memory loss interfering with work/social activities and given up chores. Depression was positively associated with the latter among women (aOR): 2.10; 95% CI: 1.09-4.06). DISCUSSION SCD interventions should include assessment of and intervention for depression, and consider age and gender differences.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Office of the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Nikki L Hill
- College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Mohammad Rifat Haider
- Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
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45
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Oliveira DVD, Morais Freire GL, Suto Aizava PV, Magna TS, Soares VN, Fernandes PT, Nascimento Júnior JRAD, Fiorese L. Intervening factors in the perception of memory decline and life purpose in older adults. REVISTA CIÊNCIAS EM SAÚDE 2021. [DOI: 10.21876/rcshci.v11i4.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To investigate the relationship between the perception of memory decline and the purpose of life in the elderly.Methods: A cross-sectional study that evaluated 235 older adults living in the city of Maringá, Paraná. A sociodemographic questionnaire, the Life Purpose Scale and the Subjective Cognitive Decline Initiative (SCD-I) were used. Data analysis was conducted using the Kolmogorov-Smirnov, Mann–Whitney “U”, Kruskal-Wallis, and Pearson's Chi-square tests (p < 0.05). Results: The results showed a higher prevalence of women with a perception of memory decline (p = 0.011) and that the elderly with more than three minimum wages had higher scores on the life purpose scale than the elderly with lower income. It was found that the elderly who does not consider that the deterioration of memory affects activities of daily living (ADL) had a greater purpose in life than the elderly who considers that the deterioration of memory impairs their ADL (p = 0.004). Conclusion: female gender seems to be a factor associated with memory decline, while higher monthly income seems to be an intervening factor in the greater purpose of life of the elderly. Not considering that memory loss harms ADLs, it seems to intervene in the best purpose of life.
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Brown MJ, Kaur A, James T, Avalos C, Addo PNO, Crouch E, Hill NL. Adverse Childhood Experiences and Subjective Cognitive Decline in the US. J Appl Gerontol 2021; 41:1090-1100. [PMID: 34898321 DOI: 10.1177/07334648211058718] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the association between adverse childhood experiences (ACEs) and subjective cognitive decline (SCD) among a representative sample of the adult US population. METHODS Data were obtained from the 2019 Behavioral Risk Factor Surveillance System (N = 82,688, ≥45 years). Adverse childhood experiences included sexual, physical/psychological and environmental ACEs, and a score. Multivariable logistic regression was used to determine the association between ACEs and SCD, and SCD-related outcomes. RESULTS Sexual (adjusted OR (aOR: 2.83; 95% CI: 2.42-3.31)), physical/psychological (aOR: 2.05; 95% CI: 1.83-2.29), and environmental (aOR: 1.94; 95% CI: 1.74-2.16) ACEs were associated with SCD in the past year. There was also a dose-response relationship between ACE score and SCD. CONCLUSION ACEs were associated with SCD. Interventions to maximize cognitive health in aging and prevent future cognitive impairment should consider the potential role of ACEs among affected populations.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,Office of the Study on Aging, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Titilayo James
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Carlos Avalos
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Prince N O Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA.,Department of Health Services Policy and Management, Arnold School of Public Health, 2629University of South Carolina, Columbia, SC, USA
| | - Nikki L Hill
- College of Nursing, Pennsylvania State University, University Park, PA, USA
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47
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Chu NM, Hong J, Harasemiw O, Chen X, Fowler KJ, Dasgupta I, Bohm C, Segev DL, McAdams-DeMarco MA. Chronic kidney disease, physical activity, and cognitive function in older adults- results from the National Health and Nutrition Examination Survey (2011-2014). Nephrol Dial Transplant 2021; 37:2180-2189. [PMID: 34850174 DOI: 10.1093/ndt/gfab338] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive impairment is common among persons with chronic kidney disease (CKD) due in part to reduced kidney function. Given that physical activity (PA) is known to mitigate cognitive decline, we examined whether associations between CKD stage and global/domain-specific cognitive function differs by PA. METHODS We leveraged 3,223 participants (aged≥60years) enrolled in National Health and Nutrition Examination Survey (NHANES,2011-2014), with at least one measure of objective cognitive function (immediate recall [CERAD-WL], delayed recall [CERAD-DR], verbal fluency [AF], executive function/processing speed [DSST], global [average of 4 tests]) or self-perceived memory decline [SCD]. We quantified the association between CKD stage (no CKD: eGFR≥60 mL/min/1.73m2 and albuminuria(ACR)<30 mg/g; stage G1-G3: eGFR≥60mL/min/1.73m2 and ACR≥30mg/g or eGFR 30-59mL/min/1.73m2; stage G4-G5: eGFR<30mL/min/1.73m2) and cognitive function using linear regression (objective measures) and logistic regression (SCD), accounting for sampling weights for nationally-representative estimates. We tested whether associations differed by physical activity (Global Physical Activity Questionnaire, high PA≥600MET*min/week vs. low PA<600MET*min/week) using a Wald test. RESULTS Among NHANES participants, 34.9% had CKD stageG1-G3, 2.6% had stageG4-G5, and 50.7% had low PA. CKD stageG4-G5 was associated with lower global cognitive function (difference = -0.38SD, 95%CI:-0.62,-0.15). This association differed by PA (pinteraction = 0.01). Specifically, among participants with low PA, those with CKD stageG4-G5 had lower global cognitive function (difference = -0.57SD, 95%CI: -0.82,-0.31) compared to those without CKD. Among those with high PA, no difference was found (difference = 0.10SD, 95%CI:-0.29,0.49). Similarly, CKD stage was only associated with immediate recall, verbal fluency, executive function, and processing speed among those with low PA; no associations were observed for delayed recall or self-perceived memory decline. CONCLUSIONS CKD is associated with lower objective cognitive function among those with low, but not high PA. Clinicians should consider screening older patients with CKD who have low PA for cognitive impairment and encourage them to meet PA guidelines.
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Affiliation(s)
- Nadia M Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jingyao Hong
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oksana Harasemiw
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Xiaomeng Chen
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kevin J Fowler
- Principal, The Voice of the Patient, Inc. Chicago, Illinois, USA
| | - Indranil Dasgupta
- University of Warwick, Heartlands Hospital Birmingham and Warwick Medical School, West Midlands, England, UK
| | - Clara Bohm
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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48
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Zygouris S, Iliadou P, Lazarou E, Giakoumis D, Votis K, Alexiadis A, Triantafyllidis A, Segkouli S, Tzovaras D, Tsiatsos T, Papagianopoulos S, Tsolaki M. Detection of Mild Cognitive Impairment in an At-Risk Group of Older Adults: Can a Novel Self-Administered Serious Game-Based Screening Test Improve Diagnostic Accuracy? J Alzheimers Dis 2021; 78:405-412. [PMID: 32986676 PMCID: PMC7683046 DOI: 10.3233/jad-200880] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Literature supports the use of serious games and virtual environments to assess cognitive functions and detect cognitive decline. This promising assessment method, however, has not yet been translated into self-administered screening instruments for pre-clinical dementia. OBJECTIVE The aim of this study is to assess the performance of a novel self-administered serious game-based test, namely the Virtual Supermarket Test (VST), in detecting mild cognitive impairment (MCI) in a sample of older adults with subjective memory complaints (SMC), in comparison with two well-established screening instruments, the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). METHODS Two groups, one of healthy older adults with SMC (N = 48) and one of MCI patients (N = 47) were recruited from day centers for cognitive disorders and administered the VST, the MoCA, the MMSE, and an extended pencil and paper neuropsychological test battery. RESULTS The VST displayed a correct classification rate (CCR) of 81.91% when differentiating between MCI patients and older adults with SMC, while the MoCA displayed of CCR of 72.04% and the MMSE displayed a CCR of 64.89%. CONCLUSION The three instruments assessed in this study displayed significantly different performances in differentiating between healthy older adults with SMC and MCI patients. The VST displayed a good CCR, while the MoCA displayed an average CCR and the MMSE displayed a poor CCR. The VST appears to be a robust tool for detecting MCI in a population of older adults with SMC.
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Affiliation(s)
- Stelios Zygouris
- School of Medicine, Aristotle University of Thessaloniki, Greece.,Network Aging Research, Heidelberg University, Germany
| | - Paraskevi Iliadou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Eftychia Lazarou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Dimitrios Giakoumis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Konstantinos Votis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Anastasios Alexiadis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Andreas Triantafyllidis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Sofia Segkouli
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Dimitrios Tzovaras
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | | | | | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
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49
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Li A, Yue L, Xiao S, Liu M. Cognitive Function Assessment and Prediction for Subjective Cognitive Decline and Mild Cognitive Impairment. Brain Imaging Behav 2021; 16:645-658. [PMID: 34491529 DOI: 10.1007/s11682-021-00545-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 11/25/2022]
Abstract
Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative dementia. Recent studies found that subjective cognitive decline (SCD) may be the early clinical precursor that precedes mild cognitive impairment (MCI) for AD. SCD subjects with normal cognition may already have some medial temporal lobe atrophy. Although brain changes by AD have been widely studied in the literature, it is still challenging to investigate the anatomical subtle changes in SCD. This paper proposes a machine learning framework by combination of sparse coding and random forest (RF) to identify the informative imaging biomarkers for assessment and prediction of cognitive functions and their changes in individuals with MCI, SCD and normal control (NC) using magnetic resonance imaging (MRI). First, we compute the volumes from both the regions of interest from whole brain and the subregions of hippocampus and amygdala as the features of structural MRIs. Then, sparse coding is applied to identify the relevant features. Finally, the proximity-based RF is used to combine three sets of volumetric features and establish a regression model for predicting clinical scores. Our method has double feature selections to better explore the relevant features for prediction and is evaluated with the T1-weighted structural MR images from 36 MCI, 112 SCD, 78 NC subjects. The results demonstrate the effectiveness of proposed method. In addition to hippocampus and amygdala, we also found that the fimbria, basal nucleus and cortical nucleus subregions are more important than other regions for prediction of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores and their changes.
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Affiliation(s)
- Aojie Li
- Department of Instrument Science and Engineering, School of EIEE, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Manhua Liu
- Department of Instrument Science and Engineering, School of EIEE, Shanghai Jiao Tong University, Shanghai, China.
- MoE Key Lab of Artificial Intelligence, AI Institute, Shanghai Jiao Tong University, Shanghai, 200240, China.
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50
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Pereiro AX, Valladares-Rodríguez S, Felpete A, Lojo-Seoane C, Campos-Magdaleno M, Mallo SC, Facal D, Anido-Rifón L, Belleville S, Juncos-Rabadán O. Relevance of Complaint Severity in Predicting the Progression of Subjective Cognitive Decline and Mild Cognitive Impairment: A Machine Learning Approach. J Alzheimers Dis 2021; 82:1229-1242. [PMID: 34151806 DOI: 10.3233/jad-210334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The presence of subjective cognitive complaints (SCCs) is a core criterion for diagnosis of subjective cognitive decline (SCD); however, no standard procedure for distinguishing normative and non-normative SCCs has yet been established. OBJECTIVE To determine whether differentiation of participants with SCD according to SCC severity improves the validity of the prediction of progression in SCD and MCI and to explore validity metrics for two extreme thresholds of the distribution in scores in a questionnaire on SCCs. METHODS Two hundred and fifty-three older adults with SCCs participating in the Compostela Aging Study (CompAS) were classified as MCI or SCD at baseline. The participants underwent two follow-up assessments and were classified as cognitively stable or worsened. Severity of SCCs (low and high) in SCD was established by using two different percentiles of the questionnaire score distribution as cut-off points. The validity of these cut-off points for predicting progression using socio-demographic, health, and neuropsychological variables was tested by machine learning (ML) analysis. RESULTS Severity of SCCs in SCD established considering the 5th percentile as a cut-off point proved to be the best metric for predicting progression. The variables with the main role in conforming the predictive algorithm were those related to memory, cognitive reserve, general health, and the stability of diagnosis over time. CONCLUSION Moderate to high complainers showed an increased probability of progression in cognitive decline, suggesting the clinical relevance of standard procedures to determine SCC severity. Our findings highlight the important role of the multimodal ML approach in predicting progression.
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Affiliation(s)
- Arturo Xosé Pereiro
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Alba Felpete
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Lojo-Seoane
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Campos-Magdaleno
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Sabela Carme Mallo
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - David Facal
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Luis Anido-Rifón
- School of Telecommunication Engineering>, University of Vigo, Vigo, Spain
| | - Sylvie Belleville
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.,Université de Montréal, Montréal, Canada
| | - Onésimo Juncos-Rabadán
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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