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Sheng M, Young K, Li Y, Zhang Y, Wang J, Jiang S. The influence of widowhood and social engagement on cognitive impairment among Chinese older adults and factors mediating their association. J Glob Health 2024; 14:04193. [PMID: 39301589 PMCID: PMC11413616 DOI: 10.7189/jogh.14.04193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024] Open
Abstract
Background Prior studies exploring the impact of widowhood on cognitive impairment in later life have been focussed on the USA and Europe. We aimed to explore the mediating role of social engagement, health behaviours, and subjective well-being in the association between widowhood and cognitive impairment in the Chinese population. Methods We conducted a study on 7796 older individuals enrolled in the 2018 wave of the Chinese Longitudinal Health Longevity Study. We used logistic regression models to analyse the impact of widowhood on cognitive health among older adults and performed mediation analysis to determine possible mediating factors in this relationship. Results Widows and widowers had a higher risk of having cognitive impairment than married older adults (95% confidence interval (CI) = 1.312, 2.279). The results from structural equation modelling (SEM) provided a good fit to the observed data (χ2 = 24.909; P = 0.00) and indicated that the effect of widowhood on cognitive impairment was partially mediated by social engagement, lifestyle behaviours, and subjective well-being (β = 0.075; P < 0.01). Conclusions Our findings contribute to existing research on the mechanisms underlying the association between widowhood and cognitive impairment among older individuals, suggesting a need for policies targeted at the specific needs of this vulnerable population, such as the maintenance of social interactions, adoption of a healthy lifestyle, improvement of subjective well-being, and provision of necessary support systems.
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Affiliation(s)
- Mingyuan Sheng
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Kathleen Young
- Department of Health Sciences, MPH and Public Health Education Programs, California State University, Northridge, California, USA
| | - Ying Li
- School of Public Health, Xi'an Medical University, Xi’an, China
| | - Yeyuan Zhang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiale Wang
- School of Nursing, Shaoxing University Yuanpei College, Shaoxing, China
| | - Shuhan Jiang
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
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Escudero B, López-Valencia L, Arias Horcajadas F, Orio L. Divergent Roles of APOAI and APOM in the Identification of Alcohol Use Disorder and Their Association With Inflammation and Cognitive Decline: A Pilot Study. Int J Neuropsychopharmacol 2024; 27:pyae029. [PMID: 38970624 PMCID: PMC11287869 DOI: 10.1093/ijnp/pyae029] [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: 02/16/2024] [Accepted: 07/04/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) courses with inflammation and cognitive decline. Apolipoproteins have emerged as novel target compounds related to inflammatory processes and cognition. METHODS A cross-sectional study was performed on abstinent AUD patients with at least 1 month of abstinence (n = 33; 72.7% men) and healthy controls (n = 34; 47.1% men). A battery of plasma apolipoproteins (APOAI, APOAII, APOB, APOCII, APOE, APOJ, and APOM), plasma inflammatory markers (LPS, LBP), and their influence on cognition and presence of the disorder were investigated. RESULTS Higher levels of plasma APOAI, APOB, APOE, and APOJ, as well as the proinflammatory LPS, were observed in the AUD group, irrespective of sex, whereas APOM levels were lower vs controls. Hierarchical logistic regression analyses, adjusting for covariates (age, sex, education), associated APOM with the absence of cognitive impairment in AUD and identified APOAI and APOM as strong predictors of the presence or absence of the disorder, respectively. APOAI and APOM did not correlate with alcohol abuse variables or liver status markers, but they showed an opposite profile in their associations with LPS (positive for APOAI; negative for APOM) and cognition (negative for APOAI; positive for APOM) in the entire sample. CONCLUSIONS The HDL constituents APOAI and APOM were differentially regulated in the plasma of AUD patients compared with controls, playing divergent roles in the disorder identification and associations with inflammation and cognitive decline.
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Affiliation(s)
- Berta Escudero
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
| | - Leticia López-Valencia
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
| | - Francisco Arias Horcajadas
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Riapad: Research Network in Primary Care in Addictions, Spain
| | - Laura Orio
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
- Riapad: Research Network in Primary Care in Addictions, Spain
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Aram J, Slopen N, Cosgrove C, Arria A, Liu H, Dallal CM. Self-Reported Disability Type and Risk of Alcohol-Induced Death - A Longitudinal Study Using Nationally Representative Data. Subst Use Misuse 2024; 59:1323-1330. [PMID: 38635979 DOI: 10.1080/10826084.2024.2340993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND Disability is associated with alcohol misuse and drug overdose death, however, its association with alcohol-induced death remains understudied. OBJECTIVE To quantify the risk of alcohol-induced death among adults with different types of disabilities in a nationally representative longitudinal sample of US adults. METHODS Persons with disabilities were identified among participants ages 18 or older in the Mortality Disparities in American Communities (MDAC) study (n = 3,324,000). Baseline data were collected in 2008 and mortality outcomes were ascertained through 2019 using the National Death Index. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated for the association between disability type and alcohol-induced death, controlling for demographic and socioeconomic covariates. RESULTS During a maximum of 12 years of follow-up, 4000 alcohol-induced deaths occurred in the study population. In descending order, the following disability types displayed the greatest risk of alcohol-induced death (compared to adults without disability): complex activity limitation (aHR = 1.7; 95% CI = 1.3-2.3), vision limitation (aHR = 1.6; 95% CI = 1.2-2.0), mobility limitation (aHR = 1.4; 95% CI = 1.3-1.7), ≥2 limitations (aHR = 1.4; 95% CI = 1.3-1.6), cognitive limitation (aHR = 1.2; 95% CI = 1.0-1.4), and hearing limitation (aHR = 1.0; 95% CI = 0.9-1.3). CONCLUSIONS The risk of alcohol-induced death varies considerably by disability type. Efforts to prevent alcohol-induced deaths should be tailored to meet the needs of the highest-risk groups, including adults with complex activity (i.e., activities of daily living - "ALDs"), vision, mobility, and ≥2 limitations. Early diagnosis and treatment of alcohol use disorder within these populations, and improved access to educational and occupational opportunities, should be considered as prevention strategies for alcohol-induced deaths.
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Affiliation(s)
- Jonathan Aram
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, USA
| | - Candace Cosgrove
- Mortality Research Group, Center for Economic Studies, U.S. Census Bureau, USA
| | - Amelia Arria
- Department of Behavioral and Community Health, University of Maryland School of Public Health, USA
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, USA
| | - Cher M Dallal
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, USA
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Wang H, Liu L, Zhou X, Guan Y, Li Y, Chen P, Duan R, Yang W, Rong X, Wu C, Yang J, Yang M, Jia Y, Hu J, Zhu X, Peng Y. Efficacy and safety of short-term edaravone or nerve growth factor add-on therapy for alcohol-related brain damage: A multi-centre randomised control trial. Addiction 2024; 119:717-729. [PMID: 38049955 DOI: 10.1111/add.16398] [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: 06/15/2022] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Abstract
AIMS To measure the therapeutic effect of an anti-oxidant, edaravone (EDV), or neurotrophic treatment with nerve growth factor (NGF) as an add-on treatment for alcohol-related brain damage (ARBD). DESIGN Multi-centre, randomised, single-blinded, comparative clinical trial. SETTING AND PARTICIPANTS One hundred and twenty-two inpatients recruited from seven hospitals in different regions of China, all diagnosed with ARBD and aged 18 to 65 years old; among them, only two were female. INTERVENTION AND COMPARATOR Patients were randomly assigned to receive one of three treatments for 2 weeks: 40 patients, treatment as usual (TAU: a combination of intramuscular injections of thiamine, intravenous infusions of other B vitamins with vitamin C and oral medication with vitamin E per day); 40, EDV add-on treatment to TAU (intravenous infusion with 30 mg of EDV twice per day); and 42, NGF add-on treatment to TAU (intramuscular injection of 20 μg of NGF per day). The patients underwent follow-up for 24 weeks. MEASUREMENTS The primary outcome was the composite score of executive cognitive function in the 2nd week after treatment, which was measured as the mean of the Z scores of the assessments, including the digit symbol substitute test (DSST), digit span memory test-forward (DST-F), digit span memory test-reverse (DST-R) and space span memory test (SSMT). The secondary outcomes were the composite scores at later follow-ups, the score for each component of cognitive function, global cognitive function measured by the Montreal Cognitive Assessment (MoCA), craving for alcohol and the safety of the therapies. FINDINGS EDV add-on treatment improved the composite score of executive cognitive function better than TAU in the 2nd week (adjusted mean difference: 0.24, 95% confidence interval 0.06 to 0.41; P = 0.008), but NGF add-on treatment did not (adjusted mean difference: 0.07, 95% confidence interval -0.09 to 0.24; P = 0.502). During the follow-up to 24 weeks, EDV add-on treatment improved the composite score of executive cognitive function and DST-R score better than TAU (both P < 0.01). Craving for alcohol was relieved in all three groups. No severe adverse events were observed. CONCLUSION The short-term addition of edaravone to supplementary therapy treatment for alcohol-related brain damage (ARBD) improved executive cognitive function in patients with ARBD.
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Affiliation(s)
- Hongxuan Wang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Liu
- Mental Health Centre, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuhui Zhou
- Hunan Provincial Brain Hospital, Changsha, China
| | - Yanzhong Guan
- Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, China
| | - Yanfei Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peiyun Chen
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ranran Duan
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weibian Yang
- Hongqi Hospital, Mudanjiang Medical University, Mudanjiang, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chengji Wu
- First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Jianzhong Yang
- Department of Psychiatry, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mei Yang
- Addiction Medicine Department, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Yanjie Jia
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian Hu
- Mental Health Centre, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaofeng Zhu
- Department of Physiology and Neurobiology, Mudanjiang Medical University, Mudanjiang, China
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Damm M, George K, Rosendahl J, Greinert R. Subclinical Cognitive Impairment in Chronic Pancreatitis Is Associated With Reduced Mobility and Quality of Life. Clin Transl Gastroenterol 2024; 15:e00685. [PMID: 38299610 DOI: 10.14309/ctg.0000000000000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
INTRODUCTION This study explores how chronic pancreatitis (CP) relates to subclinical cognitive impairment (SCI) and its prevalence, characteristics, risk factors, and effects on patients' quality of life (QoL) and physical performance. METHODS Patients with fulfilled CP criteria in imaging were prospectively enrolled. Overt encephalopathy, neurodegenerative disorders, decompensated cirrhosis, and sepsis were exclusion criteria. All patients underwent psychometric testing and assessment of health-related QoL, such as mobility and strength. SCI was diagnosed when at least 1 test of the psychometric test battery was pathological. RESULTS Seventy-one patients were enrolled. The etiology was toxic (alcohol/smoking) in most (49%) of the cases. SCI was prevalent in 41% of the patients while 25% had only 1 and 16% had 2 or more pathological tests. Patients with SCI exhibited diminished overall QoL scores ( P = 0.048), primarily affecting physical functionality ( P < 0.001). This was reaffirmed in mobility tests, where patients with SCI were slower in the timed up-and-go test ( P = 0.008) and showed increased prevalence of abnormal chair rising tests ( P = 0.004). Among all variables analyzed, only alcohol abuse was an independent risk factor of SCI (odds ratio 3.46; P = 0.02) in a multivariable regression model together with the variables age, sex, education, and compensated cirrhosis. Despite SCI affecting global QoL, sleep disturbance seemed to be the strongest variable independently associated with impaired QoL (odds ratio 9.9; P = 0.001). DISCUSSION The largest study to the subject to date shows that SCI is common in patients with CP and is linked to significant morbidity. These findings suggest the need for addressing modifiable risk factors in patients with CP to improve outcomes.
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Affiliation(s)
- Marko Damm
- Department of Internal Medicine I, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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Liu H, Chopik WJ, Shrout MR, Wang J. A national longitudinal dyadic analysis of spousal education and cognitive decline in the United States. Soc Sci Med 2024; 343:116603. [PMID: 38281387 PMCID: PMC10923139 DOI: 10.1016/j.socscimed.2024.116603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
Education plays a significant role in shaping cognitive functioning throughout an individual's life. However, existing research has not adequately explored how the educational attainment of the spouse can impact cognitive functioning over time. This study presents one of the first longitudinal analyses of how spousal education is linked to cognitive trajectories of each member within couples during their later life in the United States. Guided by the linked lives perspective, we analyze data from 8370 couples in the Health and Retirement Study spanning from 2000 to 2018. Results from the Actor-Partner Interdependence Model (APIM) integrated with latent growth curve models reveal that cognitive trajectories exhibit a correlation between spouses over time. Moreover, our analysis uncovers gender-specific effects of spousal education on cognition, shedding light on the underlying mechanisms driving this connection. Notably, the lower educational attainment of husbands is associated with a faster cognitive decline in both themselves and their wives. This association is partially explained by economic resources, but not by health and social behaviors. The lower educational attainment of wives is linked to their own faster cognitive decline as well as lower initial cognitive levels of their husbands, in part via economic resources. However, wives' educational attainment is largely unrelated to their husbands' cognitive decline. Intriguingly, wives' education has a more pronounced impact on the health and social behaviors of their husbands than vice versa, although these health and social behaviors do not appear to influence husbands' cognitive decline. In conclusion, these results underscore the importance of considering spousal education in comprehending the complexities of cognitive decline within dyadic relationships.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Purdue University, USA; Center on Aging and the Life Course, Purdue University, USA.
| | | | - M Rosie Shrout
- Center on Aging and the Life Course, Purdue University, USA; Department of Human Development and Family Science, Purdue University, USA
| | - Juwen Wang
- Department of Sociology, Purdue University, USA; Center on Aging and the Life Course, Purdue University, USA
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Escudero B, Moya M, López-Valencia L, Arias F, Orio L. Reelin Plasma Levels Identify Cognitive Decline in Alcohol Use Disorder Patients During Early Abstinence: The Influence of APOE4 Expression. Int J Neuropsychopharmacol 2023; 26:545-556. [PMID: 37350760 PMCID: PMC10464928 DOI: 10.1093/ijnp/pyad034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/21/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Apolipoprotein E (APOE)-4 isoform, reelin, and clusterin share very-low-density liporeceptor and apolipoprotein E receptor 2 receptors and are related to cognition in neuropsychiatric disorders. These proteins are expressed in plasma and brain, but studies involving plasma expression and cognition are scarce. METHODS We studied the peripheral expression (plasma and peripheral blood mononuclear cells) of these proteins in 24 middle-aged patients with alcohol use disorder (AUD) diagnosed at 4 to 12 weeks of abstinence (t = 0) and 34 controls. Cognition was assessed using the Test of Detection of Cognitive Impairment in Alcoholism. In a follow-up study (t = 1), we measured reelin levels and evaluated cognitive improvement at 6 months of abstinence. RESULTS APOE4 isoform was present in 37.5% and 58.8% of patients and controls, respectively, reaching similar plasma levels in ε4 carriers regardless of whether they were patients with AUD or controls. Plasma reelin and clusterin were higher in the AUD group, and reelin levels peaked in patients expressing APOE4 (P < .05, η2 = 0.09), who showed reduced very-low-density liporeceptor and apolipoprotein E receptor 2 expression in peripheral blood mononuclear cells. APOE4 had a negative effect on memory/learning mainly in the AUD group (P < .01, η2 = 0.15). Multivariate logistic regression analyses identified plasma reelin as a good indicator of AUD cognitive impairment at t = 0. At t = 1, patients with AUD showed lower reelin levels vs controls along with some cognitive improvement. CONCLUSIONS Reelin plasma levels are elevated during early abstinence in patients with AUD who express the APOE4 isoform, identifying cognitive deterioration to a great extent, and it may participate as a homeostatic signal for cognitive recovery in the long term.
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Affiliation(s)
- Berta Escudero
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
- Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
| | - Marta Moya
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
| | - Leticia López-Valencia
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
- Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
| | - Francisco Arias
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
- Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- RIAPAd: Research Network in Primary Care in Addictions (“Red de investigación en atención primaria en adicciones”), Spain
| | - Laura Orio
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
- Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- RIAPAd: Research Network in Primary Care in Addictions (“Red de investigación en atención primaria en adicciones”), Spain
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Kim J, Kwon KY. Investigating Heterogeneity in the Relationship Between Marital Satisfaction and Cognitive Health by Gender and Across the Cognitive Function Distribution. Innov Aging 2023; 7:igad079. [PMID: 37727598 PMCID: PMC10506168 DOI: 10.1093/geroni/igad079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Indexed: 09/21/2023] Open
Abstract
Background and Objectives Marital satisfaction has been established as an essential factor for promoting health and well-being in older adults. However, it is unclear whether marital satisfaction is also associated with cognitive health in this population. This study aimed to investigate the longitudinal association between marital satisfaction and cognitive function, while also exploring variations in this relationship by gender and across the cognitive function distribution. Research Design and Methods This study used 6 waves of the Korean Longitudinal Study of Ageing (KLoSA) and employed gender-stratified unconditional quantile regression (UQR) models with fixed effects (FE) to estimate the association between marital satisfaction and cognitive function across different quantiles of the cognitive function distribution. FE models controlled for unobserved individual-level confounders such as genetics, cognitive and noncognitive skills, and early childhood social and cultural background. Results The results of this study revealed that marital satisfaction was positively associated with cognitive function (b = 0.305), and this association was stronger in older men than in older women (b = 0.392 for older men vs b = 0.181 for older women). The UQR-FE models suggested that stronger association between marital satisfaction and cognitive function was observed among older men with lower cognitive function (b = 0.817 for 10th percentile vs b = 0.118 for 90th percentile). Among older women, no clear patterns of heterogeneity were found across the cognitive function distribution. Discussion and Implications The findings of this study highlight a significant degree of heterogeneity in the relationship between marital satisfaction and cognitive function among older men, with stronger associations observed in the lower percentiles of the cognitive function distribution. Interventions aimed at improving marital quality could be an effective strategy for promoting cognitive health in older adults, with an approach tailored to the individual's characteristics.
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Affiliation(s)
- Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
| | - Keun Young Kwon
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
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Zhang Y, Fletcher J, Lu Q, Song J. Gender differences in the association between parity and cognitive function: Evidence from the UK biobank. Soc Sci Med 2023; 320:115649. [PMID: 36709690 PMCID: PMC9974636 DOI: 10.1016/j.socscimed.2022.115649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/05/2023]
Abstract
While much previous work linking fertility history with late-life cognition has focused on a narrow set of cognitive measures and/or has used modest sample sizes in the analysis, our paper expands the size and scope of these linkages by analyzing cognitive function across five domains and precisely estimating gendered patterns between men and women. Results point to important gendered associations between parity and cognition: having children is likely associated with better cognitive function for fathers in all five domains. However, mothers show worse cognitive function in some domains (i.e., numeric memory, prospective memory, and fluid intelligence) than childless women. We explore the possibility of confounding in these associations and rule out the effects of genetic cognitive ability on fertility. We also find that adding controls for educational attainment differ by gender-strengthening associations between parity and cognition for men and largely eliminating them for women. The findings support previous work done on how life course contexts may link to the risk of dementia or cognitive impairment, highlighting parity as potential protective or risk factors to parents' cognitive health. The use of five cognitive domains yields variations in results, giving implications on measure selection of cognitive function and calling for replicated work covering more cognitive domains.
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Affiliation(s)
- Yan Zhang
- Center for Demography of Health and Aging, University of Wisconsin, Madison, United States.
| | - Jason Fletcher
- Center for Demography of Health and Aging, University of Wisconsin, Madison, United States.
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, United States.
| | - Jie Song
- Department of Statistics, University of Wisconsin, Madison, United States.
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Jones L, Owens L, Thompson A, Gilmore I, Richardson P. Informing the development of diagnostic criteria for differential diagnosis of alcohol-related cognitive impairment (ARCI) among heavy drinkers: A systematic scoping review. PLoS One 2023; 18:e0280749. [PMID: 36753517 PMCID: PMC9907814 DOI: 10.1371/journal.pone.0280749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 01/08/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Early detection and diagnosis of alcohol-related cognitive impairment (ARCI) among heavy drinkers is crucial to facilitating appropriate referral and treatment. However, there is lack of consensus in defining diagnostic criteria for ARCI. Uncertainty in attributing a diagnosis of suspected ARCI commonly arises in clinical practice and opportunities to intervene are missed. A systematic scoping review approach was taken to (i) summarise evidence relating to screening or diagnostic criteria used in clinical studies to detect ARCI; and (ii) to determine the extent of the research available about cognitive assessment tools used in 'point-of-care' screening or assessment of patients with suspected non-Korsakoff Syndrome forms of ARCI. METHODS We searched Medline, PsycINFO, Cinahl and the Web of Science, screened reference lists and carried out forward and backwards citation searching to identify clinical studies about screening, diagnosis or assessment of patients with suspected ARCI. RESULTS In total, only 7 studies met our primary objective and reported on modifications to existing definitions or diagnostic criteria for ARCI. These studies revealed a lack of coordinated research and progress towards the development and standardisation of diagnostic criteria for ARCI. Cognitive screening tools are commonly used in practice to support a diagnosis of ARCI, and as a secondary objective we included an additional 12 studies, which covered a range of settings and patient populations relevant to screening, diagnosis or assessment in acute, secondary or community 'point-of-care' settings. Across two studies with a defined ARCI patient sample and a further four studies with an alcohol use disorder patient sample, the accuracy, validity and/or reliability of seven different cognitive assessment tools were examined. The remaining seven studies reported descriptive findings, demonstrating the lack of evidence available to draw conclusions about which tools are most appropriate for screening patients with suspected ARCI. CONCLUSION This review confirms the scarcity of evidence available on the screening, diagnosis or assessment of patients with suspected ARCI. The lack of evidence is an important barrier to the development of clear guidelines for diagnosing ARCI, which would ultimately improve the real-world management and treatment of patients with ARCI.
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Affiliation(s)
- Lisa Jones
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
- * E-mail:
| | - Lynn Owens
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Department of Gastroenterology and Hepatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Andrew Thompson
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Ian Gilmore
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Paul Richardson
- Liverpool Centre for Alcohol Research, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
- Department of Gastroenterology and Hepatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
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Bach P, de Timary P, Gründer G, Cumming P. Molecular Imaging Studies of Alcohol Use Disorder. Curr Top Behav Neurosci 2023. [PMID: 36639552 DOI: 10.1007/7854_2022_414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Alcohol use disorder (AUD) is a serious public health problem in many countries, bringing a gamut of health risks and impairments to individuals and a great burden to society. Despite the prevalence of a disease model of AUD, the current pharmacopeia does not present reliable treatments for AUD; approved treatments are confined to a narrow spectrum of medications engaging inhibitory γ-aminobutyric acid (GABA) neurotransmission and possibly excitatory N-methyl-D-aspartate (NMDA) receptors, and opioid receptor antagonists. Molecular imaging with positron emission tomography (PET) and single-photon emission computed tomography (SPECT) can open a window into the living brain and has provided diverse insights into the pathology of AUD. In this narrative review, we summarize the state of molecular imaging findings on the pharmacological action of ethanol and the neuropathological changes associated with AUD. Laboratory and preclinical imaging results highlight the interactions between ethanol and GABA A-type receptors (GABAAR), but the interpretation of such results is complicated by subtype specificity. An abundance of studies with the glucose metabolism tracer fluorodeoxyglucose (FDG) concur in showing cerebral hypometabolism after ethanol challenge, but there is relatively little data on long-term changes in AUD. Alcohol toxicity evokes neuroinflammation, which can be tracked using PET with ligands for the microglial marker translocator protein (TSPO). Several PET studies show reversible increases in TSPO binding in AUD individuals, and preclinical results suggest that opioid-antagonists can rescue from these inflammatory responses. There are numerous PET/SPECT studies showing changes in dopaminergic markers, generally consistent with an impairment in dopamine synthesis and release among AUD patients, as seen in a number of other addictions; this may reflect the composite of an underlying deficiency in reward mechanisms that predisposes to AUD, in conjunction with acquired alterations in dopamine signaling. There is little evidence for altered serotonin markers in AUD, but studies with opioid receptor ligands suggest a specific up-regulation of the μ-opioid receptor subtype. Considerable heterogeneity in drinking patterns, gender differences, and the variable contributions of genetics and pre-existing vulnerability traits present great challenges for charting the landscape of molecular imaging in AUD.
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Affiliation(s)
- Patrick Bach
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.
| | - Philippe de Timary
- Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc and Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Gerhard Gründer
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
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Angerville B, Ritz L, Pitel AL, Beaunieux H, Houchi H, Martinetti MP, Naassila M, Dervaux A. Early Improvement of Neuropsychological Impairments During Detoxification in Patients with Alcohol Use Disorder. Alcohol Alcohol 2023; 58:46-53. [PMID: 36221321 DOI: 10.1093/alcalc/agac048] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/19/2022] [Accepted: 09/02/2022] [Indexed: 01/12/2023] Open
Abstract
AIMS To assess recovery of alcohol-related neuropsychological deficits in a group of patients with pure severe alcohol use disorder (AUD) during a detoxification program using the Brief Evaluation of Alcohol-Related Neuropsychological Impairment (BEARNI) test. METHODS Thirty-two patients with severe AUD using DSM-IV criteria (24 men, mean age = 45.5 ± 6.8 years old) were assessed using the BEARNI 8 ± 2 days after alcohol cessation (T1) and then were reassessed within 18 ± 2 days after alcohol cessation (T2). The primary study endpoint was the number of patients initially impaired at T1 who recovered cognitive functions at T2 assessment. RESULTS At T1, 59% (n = 19) patients with pure severe AUD had at least one impaired cognitive function assessed by the BEARNI. At T2, 63% of the patients with AUD with deficits at T1 had normal BEARNI cognitive scores (χ2 = 7.7, P = 0.005); specifically, the percentages of participants with normal subtest scores were 63% on memory (χ2 = 12.4, P = 0.0004), 100% on verbal fluency (χ2 = 16; P = <0.0001), 60% on alphabetical span (χ2 = 12.8; P = 0.0003) and 67% on visuospatial (χ2 = 15, P = 0.0001). CONCLUSIONS The cognitive impairments of two-thirds of patients with pure AUD included in the present study recovered within 18 days of abstinence, earlier than reported in previous studies.
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Affiliation(s)
- Bernard Angerville
- Service de Psychiatrie et Addictologie de liaison, CHU Sud, 80054 Amiens Cedex, France.,Université de Picardie Jules Verne. Groupe de Recherche sur l'Alcool & les Pharmacodépendances (GRAP) INSERM U1247, 80054 Amiens, France
| | - Ludivine Ritz
- Université de Caen Normandie, Laboratoire de Psychologie Caen Normandie (LPCN; EA 7452), 14000 Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Hélène Beaunieux
- Université de Caen Normandie, Laboratoire de Psychologie Caen Normandie (LPCN; EA 7452), 14000 Caen, France
| | - Hakim Houchi
- Université de Picardie Jules Verne. Groupe de Recherche sur l'Alcool & les Pharmacodépendances (GRAP) INSERM U1247, 80054 Amiens, France
| | - Margaret P Martinetti
- Université de Picardie Jules Verne. Groupe de Recherche sur l'Alcool & les Pharmacodépendances (GRAP) INSERM U1247, 80054 Amiens, France.,The College of New Jersey, Department of Psychology, Ewing, NJ 08618, USA
| | - Mickaël Naassila
- Université de Picardie Jules Verne. Groupe de Recherche sur l'Alcool & les Pharmacodépendances (GRAP) INSERM U1247, 80054 Amiens, France
| | - Alain Dervaux
- Service de Psychiatrie et Addictologie de liaison, CHU Sud, 80054 Amiens Cedex, France.,Université de Picardie Jules Verne. Groupe de Recherche sur l'Alcool & les Pharmacodépendances (GRAP) INSERM U1247, 80054 Amiens, France
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13
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Zhang Y. Fertility History and Risk of Cognitive Impairment Among Older Parents in the United States. J Gerontol B Psychol Sci Soc Sci 2022; 77:2326-2337. [PMID: 35796743 PMCID: PMC9799211 DOI: 10.1093/geronb/gbac091] [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: 11/10/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES I work from a gendered life-course perspective to examine the association between older parents' fertility history (i.e., timing and parity) and their risk of cognitive impairment in the United States. METHODS I analyze nationally representative data from 9 waves over 16 years of the Health and Retirement Study (2000-2016). The sample includes 14,543 respondents (6,108 men and 8,435 women) aged 50 and older at the baseline survey. I examine the relationship between parity, age at first birth, and age at last birth with risk of cognitive impairment using nonlinear discrete-time hazard models. RESULTS Adjusting for the effects of full covariates, there are U-shaped relationships between women's age at last birth and risk of cognitive impairment and between women's parity and risk of cognitive impairment. In the sensitivity tests, the relationships remain robust when sampling weights are applied, or mortality selection is corrected. DISCUSSION Fertility timing and parity are likely factors associated with the risk of cognitive impairment for older women. Understanding fertility history and its impact on cognition can help identify the most vulnerable subpopulations, so that more effective interventions can be made to improve cognitive functioning among older adults.
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Affiliation(s)
- Yan Zhang
- Center for Demography of Health and Aging, University of Wisconsin–Madison, Madison, Wisconsin, USA
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14
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Banjac Baljak V, Mihajlovic G, Zivlak-Radulovic N, Nezic L, Miskovic M, Banjac V. Association between Vitamin D and Cognitive Deficiency in Alcohol Dependence. Healthcare (Basel) 2022; 10:healthcare10091772. [PMID: 36141384 PMCID: PMC9498855 DOI: 10.3390/healthcare10091772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/22/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
There are still not enough findings to elucidate how exactly alcohol use impairs cognitive abilities. Some studies have shown that there is a link between alcohol intake and vitamin D levels, but these findings are inconsistent so further research is needed. The aim of this study was to investigate the association between serum vitamin D levels and cognitive impairment in alcohol-dependent individuals. A case-control study was carried out including a total of N = 132 respondents with a medical history of alcoholism, and healthy volunteers. The Montreal Cognitive Assessment (MoCa) and Addenbrooke’s Cognitive Examination-Revised (ACE-R) screening tools were used for cognitive status assessment and serum vitamin D levels analysis (blood samples of respondents). Significant difference (p = 0.022), was found in vitamin D levels in the alcohol-dependent group with cognitive deficiency 13.7 ± 9.4 (ng/mL), alcohol-dependent group without cognitive deficiency 19.5 ± 11.2 (ng/mL) and healthy controls 19.9 ± 11.1 (ng/mL), respectively. Furthermore, vitamin D levels were significantly different across all groups based on MoCa (p = 0.016) and ACE-R (p = 0.004) scores. All three groups exhibited vitamin D deficiency. A significant correlation was found between vitamin D deficiency and cognitive impairment, but it yielded no significant difference in alcohol-dependent individuals.
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Affiliation(s)
- Visnja Banjac Baljak
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, 78 000 Banjaluka, Bosnia and Herzegovina
- Correspondence: ; Tel.: +387-65-462-496
| | - Goran Mihajlovic
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 34 000 Kragujevac, Serbia
| | - Nera Zivlak-Radulovic
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, 78 000 Banjaluka, Bosnia and Herzegovina
| | - Lana Nezic
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78 000 Banja Luka, Bosnia and Herzegovina
| | - Mirjana Miskovic
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, 78 000 Banjaluka, Bosnia and Herzegovina
| | - Vesna Banjac
- Department of Pharmacy, Faculty of Medicine, University of Banja Luka, 78 000 Banja Luka, Bosnia and Herzegovina
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15
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Stuart G, Hing N, Russell AMT. Interactive Effects of Problem-Gambling Severity, Gender and Alcohol Consumption on Electronic Gaming Machine Behaviour. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00849-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Abstract
While comorbidity of problematic alcohol and gambling use is well established, much less is known about the way in which alcohol consumption while gambling interacts with problem-gambling severity and other individual differences. We hypothesised three factors that would interact with alcohol consumption while gambling on electronic gaming machines (EGMs) to influence four behavioural gambling measures: preferred number of lines bet, average duration of play, average spend per session and preferred electronic gaming machine denomination. The latter is a measure of gambler’s preference for the monetary denomination in which EGM bets are placed (e.g. 1 cent, 2 cents, 5 cents, 10 cents, 20 cents, $1), with higher denomination EGMs being higher risk since bets can be placed in larger amounts and money can be lost more rapidly. The three hypothesised interacting factors were problem-gambling severity, presence/absence of alcohol use disorder and biological gender. A total of 1557 male and female participants completed a questionnaire, measuring their problem-gambling status, problem alcohol status, consumption of alcohol at the gambling venue, preferred EGM denomination, preferred number of lines bet, average duration of play and average spend per session. We found the anticipated gender-differential spending effect with males spending more than females, but we also found a surprising reverse differential spending effect for problem gamblers such that females spent more than males. We also found that alcohol consumption while gambling was generally associated with a preference for higher denomination machines and that those players without alcohol problems who drank at the venue preferred to bet on more lines, suggesting a double-max strategy amongst gamblers who drank at the venue. Finally, for non-problem and low-risk gamblers, concurrent alcohol consumption was related to preference for higher denomination EGMs in female players, but not for male players. These findings are discussed in the context of the physiological and psychological effects of alcohol.
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16
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Jain U, Liu H, Langa KM, Farron M, Kabeto M, Lee J. Widowhood and cognition among older women in India: New insights on widowhood duration and mediators. SSM Popul Health 2022; 19:101242. [PMID: 36193099 PMCID: PMC9525895 DOI: 10.1016/j.ssmph.2022.101242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 01/10/2023] Open
Abstract
Background Widowhood, a marital status that disproportionately affects older women, has been associated with poorer health compared to married individuals. However, relatively little is known about the association between widowhood in later-life and cognitive health in low- and middle-income countries. Methods To address this research gap, we used data from the Longitudinal Aging Study in India (2017-19) to investigate the widowhood disparity in cognitive health among mid-aged and older women in India, including how this relationship varies by the duration of widowhood. We further examined the extent to which economic, social, and health conditions mediate this association. Results Cognition scores for widowed women were on average lower by almost 0.1 standard deviations compared to married women. Overall, this disparity increased with widowhood duration, with non-linearities in this association. The disparity in cognition scores increased with widowhood duration up to twenty years but did not increase further among those with longer widowhood duration. Worse physical and mental health were found to mediate almost thirty percent of the total association between widowhood and cognition. These mediators were most useful in explaining the association between lower cognition and widowhood among women who experienced widowhood for ten years or longer. Conclusion The study highlights the significant disadvantage in cognitive functioning among older widowed women in India. The study also provides evidence on potential mediators, suggesting differential effects of mediators at different stages of widowhood.
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Affiliation(s)
- Urvashi Jain
- Department of Economics, Finance and Real Estate, Mitchell College of Business, University of South Alabama, USA
| | - Hui Liu
- Department of Sociology, Michigan State University, USA
| | - Kenneth M. Langa
- Department of Internal Medicine, Institute for Social Research, and VA Center for Clinical Management Research, University of Michigan, USA
| | - Madeline Farron
- Department of Internal Medicine, University of Michigan, USA
| | - Mohammed Kabeto
- Department of Internal Medicine, University of Michigan, USA
| | - Jinkook Lee
- Center for Economic and Social Research, and Department of Economics, University of Southern California, USA
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17
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Liu H, Lin Z, Umberson D. Parental Death and Cognitive Impairment: An Examination by Gender and Race-Ethnicity. J Gerontol B Psychol Sci Soc Sci 2022; 77:1164-1176. [PMID: 34230956 PMCID: PMC9159058 DOI: 10.1093/geronb/gbab125] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES We provide the first nationally representative longitudinal study of cognitive impairment in relation to parental death from childhood through early adulthood, midlife, and later adulthood, with attention to heterogeneity in the experience of parental death. METHODS We analyzed data from the Health and Retirement Study (2000-2016). The sample included 13,392 respondents, contributing 72,860 person-periods. Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Discrete-time hazard regression models were estimated to predict the odds of cognitive impairment. RESULTS Both exposure and timing of parental death were related to the risk of cognitive impairment in late life and associations vary by gender. The detrimental effect of a father's death was comparable for daughters and sons although exposure to a mother's death had stronger effects on daughter's than son's risk of cognitive impairment. Father's death at younger ages had the strongest effect on sons' late-life risk of cognitive impairment, whereas mother's death in middle adulthood had the strongest effect on daughters' risk. We found no significant racial-ethnic variation in the association between parental death and cognitive impairment. DISCUSSION It is important to explore the gender-specific pathways through which parental death leads to increased risk of cognitive impairment so that effective interventions can be implemented to reduce risk.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, East Lansing, USA
| | - Zhiyong Lin
- Center on Aging and Population Sciences and Population Research Center, The University of Texas at Austin, USA
| | - Debra Umberson
- Department of Sociology, Center on Aging and Population Sciences and Population Research Center, The University of Texas at Austin, USA
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18
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Vascular Endothelial Growth Factor as a Potential Biomarker of Neuroinflammation and Frontal Cognitive Impairment in Patients with Alcohol Use Disorder. Biomedicines 2022; 10:biomedicines10050947. [PMID: 35625687 PMCID: PMC9138236 DOI: 10.3390/biomedicines10050947] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Alcohol Use Disorder (AUD) is associated with functional disruption of several brain structures that may trigger cognitive dysfunction. One of the mechanisms of alcohol-associated cognitive impairment has been proposed to arise from its direct impact on the immune system, which culminates in the release of cytokines and chemokines which can eventually reach the brain. Alcohol can also disrupt the blood–brain barrier, facilitating the penetration of pro-inflammatory molecules throughout vascular endothelial growth factor A (VEGFA). Thus, alcohol-induced alterations in chemokines and VEGFA might contribute to the neuroinflammation and cognitive impairment associated with AUD. (2) Methods: The present cross-sectional study investigates whether patients with AUD (n = 86) present cognitive disability associated to alterations in plasma concentration of SDF-1, fractalkine, eotaxin, MCP-1, MIP-1α and VEGFA when compared to control subjects (n = 51). (3) Results: The analysis indicated that SDF-1 and MCP-1 concentrations were higher in AUD patients than in controls. Concentrations of VEGFA were higher in AUD patients with severe frontal deficits, and the score of frontal lobe functions was negatively correlated with VEGFA and fractalkine. Acute alcohol effects on VEGFA plasma levels in healthy volunteers demonstrated the induction of VEGFA release by heavy alcohol drinking. VEGFA was positively correlated with pro-inflammatory chemokines in AUD patients with frontal cognitive impairment. (4) Conclusions: we propose VEGFA/chemokine monitoring as biomarkers of potential cognitive impairment in AUD patients.
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Kamsvaag B, Tevik K, Šaltytė Benth J, Wu B, Bergh S, Selbaek G, Helvik AS. Does Elevated Alcohol Consumption Delay the Diagnostic Assessment of Cognitive Impairment among Older Adults? Dement Geriatr Cogn Dis Extra 2022; 12:14-23. [PMID: 35350466 PMCID: PMC8921958 DOI: 10.1159/000521924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction The time from symptom debut to assessment of cognitive impairment (TSA) is usually substantial, and many factors can influence the length of this interval. Our objective was to discern whether elevated alcohol consumption is associated with TSA. Methods Alcohol consumption was measured among 3,236 older Norwegians assessed for cognitive impairment. Elevated consumption was defined as drinking 4–7 times a week. TSA was defined as the number of months between symptom debut and assessment. The association between alcohol consumption and TSA was examined with a multiple regression analysis controlled for sociodemographic and clinical covariates. Results Mean (SD) and median TSA were 34.8 (35.8) and 24.0 months, respectively. Elevated alcohol consumption was not associated with TSA. Longer TSA was associated with being male, having a high education level, being retired or unemployed, being single, having low scores on the Mini-Mental State Examination (MMSE) or Personal Activities of Daily Living (PADL), having high subsyndrome scores of depression or agitation on The Neuropsychiatric Inventory − Questionnaire (NPI-Q), or having a spouse/cohabitant as the designated next of kin. Conclusion This study indicates that elevated alcohol consumption does not influence TSA. Possible explanations are discussed, but further research is needed to determine the effect of alcohol definitively. We did identify other novel characteristics associated with TSA which may be important in minimizing the risk of delayed cognitive assessments and should be kept in mind when considering assessment.
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Affiliation(s)
- Ben Kamsvaag
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- *Ben Kamsvaag,
| | - Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jūratė Šaltytė Benth
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Sverre Bergh
- Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne-Sofie Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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20
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Zhang Y, Fletcher J. Parental status in later life and parents' risk of cognitive impairment. SSM Popul Health 2021; 16:100968. [PMID: 34825046 PMCID: PMC8605109 DOI: 10.1016/j.ssmph.2021.100968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/29/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022] Open
Abstract
Parental status can influence parents’ well-being in significant ways, but little research has examined its impact on older adults’ cognitive health in the U.S. Using data from the National Health and Aging Trends Study (NHATS) 2011–2019, this study examines whether parental status is related to the risk of cognitive impairment among older adults in the U.S. We found that the presence of adult children (i.e., having at least one living adult child) was associated with a lower risk of cognitive impairment for older parents. Moreover, compared to childless older adults, older parents who had three and more children, who had adult daughter(s), and who had biological/adopted adult children displayed a significantly lower risk of cognitive impairment. This study highlights the importance of adult children as resources of support and caring that may benefit older parents’ cognitive health. The findings can help to identify the most vulnerable subpopulations among aging adults so that medical workers and policy makers can design effective strategies to protect cognitive function for those “at risk” older adults. Parental status is an important factor related to older adults’ cognitive health. Presence of adult children was associated with a lower risk of cognitive impairment than being childlessness. Having 3+ children, adult daughter(s), or biological children was associated with lower risk of cognitive impairment.
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Affiliation(s)
- Yan Zhang
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - Jason Fletcher
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
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21
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Liu H, Hsieh N, Zhang Z, Zhang Y, Langa KM. Same-Sex Couples and Cognitive Impairment: Evidence From the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:1388-1399. [PMID: 33211882 PMCID: PMC8499509 DOI: 10.1093/geronb/gbaa202] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES We provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States. METHODS We analyzed data from the Health and Retirement Study (2000-2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment. RESULTS The estimated odds of cognitive impairment were 78% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98% vs. 5.42% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (odds ratio = 1.53, p < .001). DISCUSSION The findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State
University, East Lansing
| | - Ning Hsieh
- Department of Sociology, Michigan State
University, East Lansing
| | - Zhenmei Zhang
- Department of Sociology, Michigan State
University, East Lansing
| | - Yan Zhang
- Department of Sociology, Michigan State
University, East Lansing
| | - Kenneth M Langa
- Department of Internal Medicine, Institute for Social
Research and VA Center for Clinical Management Research, University of
Michigan, Ann Arbor
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Requena-Ocaña N, Araos P, Flores M, García-Marchena N, Silva-Peña D, Aranda J, Rivera P, Ruiz JJ, Serrano A, Pavón FJ, Suárez J, Rodríguez de Fonseca F. Evaluation of neurotrophic factors and education level as predictors of cognitive decline in alcohol use disorder. Sci Rep 2021; 11:15583. [PMID: 34341419 PMCID: PMC8328971 DOI: 10.1038/s41598-021-95131-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023] Open
Abstract
Cognitive reserve (CR) is the capability of an individual to cope with a brain pathology through compensatory mechanisms developed through cognitive stimulation by mental and physical activity. Recently, it has been suggested that CR has a protective role against the initiation of substance use, substance consumption patterns and cognitive decline and can improve responses to treatment. However, CR has never been linked to cognitive function and neurotrophic factors in the context of alcohol consumption. The present cross-sectional study aims to evaluate the association between CR (evaluated by educational level), cognitive impairment (assessed using a frontal and memory loss assessment battery) and circulating levels of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in patients with alcohol use disorder (AUD). Our results indicated that lower educational levels were accompanied by earlier onset of alcohol consumption and earlier development of alcohol dependence, as well as impaired frontal cognitive function. They also suggest that CR, NT-3 and BDNF may act as compensatory mechanisms for cognitive decline in the early stages of AUD, but not in later phases. These parameters allow the identification of patients with AUD who are at risk of cognitive deterioration and the implementation of personalized interventions to preserve cognitive function.
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Affiliation(s)
- Nerea Requena-Ocaña
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain.
- School of Psychology, Complutense University of Madrid, Madrid, Spain.
- Laboratorio de Investigación, IBIMA, Hospital Universitario Regional de Málaga, Avenida Carlos Haya 82, 29010, Málaga, Spain.
| | - Pedro Araos
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, School of Psychology, University of Málaga, 29010, Málaga, Spain
| | - María Flores
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Nuria García-Marchena
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Daniel Silva-Peña
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Jesús Aranda
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
- School of Medicine, University of Málaga, 29071, Málaga, Spain
| | - Patricia Rivera
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Juan Jesús Ruiz
- Provincial Drug Addiction Center of Málaga, Provincial Council of Málaga, Málaga, Spain
| | - Antonia Serrano
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
| | - Francisco Javier Pavón
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain
- Cardiac Clinical Management Unit, IBIMA, University Hospital Virgen de la Victoria, 29010, Málaga, Spain
| | - Juan Suárez
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain.
- Department of Human Anatomy, Legal Medicine and History of Science, IBIMA, Facultad de Medicina, University of Málaga, Bulevar Louis Pausteur, 29071, Málaga, Spain.
| | - Fernando Rodríguez de Fonseca
- Mental Health Clinical Management Unit, Institute of Biomedical Research of Malaga-IBIMA, Regional University Hospital of Málaga, 29010, Málaga, Spain.
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23
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Caballeria E, Maier M, Balcells-Oliveró M, López-Pelayo H, Oliveras C, Rubio Ballester B, Verschure PFMJ, Gual A. Rehabilitation Gaming System for Alcohol-Related Cognitive Impairment: A Pilot Usability Study. Alcohol Alcohol 2021; 57:595-601. [PMID: 34212185 DOI: 10.1093/alcalc/agab043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/13/2021] [Accepted: 06/01/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS Cognitive impairment in patients with alcohol use disorder (AUD) is highly prevalent, and it negatively impacts treatment outcome. However, this condition is neither systematically assessed nor treated. Thus, we aimed to explore the usability of a virtual reality-based protocol ('Rehabilitation Gaming System', RGS) for patients with AUD. METHODS Twenty AUD patients (50% also cognitive impairment) underwent a single session of the RGS protocol (four cognitive training tasks, 10 minutes each). System Usability Scale (SUS) and Post-Study System Usability Questionnaire (PSSUQ) were applied to assess the RGS usability and patients' satisfaction with it. Also, the Perceived Competence Scale was administered to assess the patients' feelings of competence when using the training protocol. Comparisons of the responses to these questionnaires were performed between AUD patients with cognitive impairment and those without cognitive impairment. RESULTS RGS usability was very positively rated (median SUS score = 80, Interquartile Range, IQR = 68.13-86-88). No significant differences were found in the median SUS scores for any of the sociodemographic or clinical variables, excepting for gender (women median score = 85; IQR = 80-94.38 vs. men median score = 71.25; IQR = 61.25-89.25; P-value = 0.035). The quality of the information provided by the RGS training scenarios and the usability were positively rated (PSSUQ), and patients experienced high feelings of competence. CONCLUSIONS The RGS has been found to be usable in the short term and patients with AUD stated to be satisfied with it. Future larger, randomized trials are needed to explore the effectiveness of this tool to help overcome the cognitive deficits in AUD patients.
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Affiliation(s)
- Elsa Caballeria
- Grup Recerca Addicions Clínic (GRAC-GRE), Addictions Unit, Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS, RTA (RETICS), Villarroel, 170, Barcelona 08036, Spain
| | - Martina Maier
- Laboratory of Synthetic, Perceptive, Emotive and Cognitive Systems (SPECS), Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Av. d'Eduard Maristany 10-14, Barcelona 08930, Spain
| | - Mercedes Balcells-Oliveró
- Grup Recerca Addicions Clínic (GRAC-GRE), Addictions Unit, Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS, RTA (RETICS), Villarroel, 170, Barcelona 08036, Spain
| | - Hugo López-Pelayo
- Grup Recerca Addicions Clínic (GRAC-GRE), Addictions Unit, Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS, RTA (RETICS), Villarroel, 170, Barcelona 08036, Spain
| | - Clara Oliveras
- Grup Recerca Addicions Clínic (GRAC-GRE), Addictions Unit, Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS, RTA (RETICS), Villarroel, 170, Barcelona 08036, Spain
| | - Belén Rubio Ballester
- Laboratory of Synthetic, Perceptive, Emotive and Cognitive Systems (SPECS), Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Av. d'Eduard Maristany 10-14, Barcelona 08930, Spain
| | - Paul F M J Verschure
- Laboratory of Synthetic, Perceptive, Emotive and Cognitive Systems (SPECS), Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Av. d'Eduard Maristany 10-14, Barcelona 08930, Spain.,Institució Catalana de Recerca I Estudis Avançats (ICREA), Passeig de Lluís Companys, 23, Barcelona 08010, Spain
| | - Antoni Gual
- Grup Recerca Addicions Clínic (GRAC-GRE), Addictions Unit, Department of Psychiatry and Psychology, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS, RTA (RETICS), Villarroel, 170, Barcelona 08036, Spain
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24
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Liu H, Zhang Z, Zhang Y. A national longitudinal study of marital quality and cognitive decline among older men and women. Soc Sci Med 2021; 282:114151. [PMID: 34174580 DOI: 10.1016/j.socscimed.2021.114151] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022]
Abstract
We provide one of the first national longitudinal studies of the association between trajectories of marital quality and cognitive functioning among older adults, with close attention paid to gender differences. Data were drawn from the Health and Retirement Study (HRS) 2006-2016. Marital quality trajectories were assessed at three waves: 2006/2008, 2010/2012, and 2014/2016. Cognitive trajectories were assessed at five waves: 2008, 2010, 2012, 2014, and 2016. The final analytic sample included 7901 respondents age 50 and older (4334 men and 3567 women) who were either married or cohabiting during the study period. Results from parallel linear growth curve models suggest that among older adults, initial positive marital quality was associated with better initial cognition, and initial negative marital quality was associated with worse initial cognition. Results from multiple group analysis further suggest that marital quality was significantly associated with men's cognitive trajectories but not women's. Among men, an increase in positive marital quality was associated with a slower rate of cognitive decline, whereas an increase in negative marital quality was associated with a faster rate of cognitive decline. These findings suggest that older men who experience a decline in marital quality may be vulnerable to cognitive decline and that reducing marital strain and improving marital quality may protect men's cognitive health in later life.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, East Lansing, MI, USA.
| | - Zhenmei Zhang
- Department of Sociology, Michigan State University, East Lansing, MI, USA
| | - Yan Zhang
- Department of Sociology, Michigan State University, East Lansing, MI, USA
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25
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Mistarz N, Andersen K, Nielsen AS, Goudriaan AE, Michel TM, Skøt L, Nielsen DG, Mellentin AI. Pharmacological enhancing agents targeting cognition in patients with alcohol-induced neurocognitive disorders: A systematic review. Neurosci Biobehav Rev 2021; 125:608-626. [PMID: 33667552 DOI: 10.1016/j.neubiorev.2021.02.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 11/18/2022]
Abstract
Debilitating neurocognitive deficits are seen in alcohol use disorders (AUD) and Wernicke-Korsakoff's syndrome (WKS). These shared characteristics suggest a spectrum of alcohol-induced neurocognitive disorders (AIND). Cognitive pharmacological enhancing agents (CPEA) have been examined in the treatment of other psychiatric disorders, but little is known about the effects of these agents on AINDs. Our aim was to synthesize the evidence for the effectiveness of CPEAs on AINDs. Databases were searched for controlled trials examining CPEAs on AUD, WKS, and alcohol-related dementia (ARD). Eligible studies were included in a qualitative synthesis and a quality assessment was conducted. The search identified 23 studies (4 ≤ ns ≤ 98). Evidence suggests that modafinil may improve executive functions in AUD and ARD, but this effect may only be present in patients with severe deficits. The studies were rated as having a moderate risk of bias. Despite the promising effects of modafinil, small samples and inconsistent evidence deem the results preliminary. More research is warranted examining the effects of transdiagnostic CPEAs on deficits across AINDs.
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Affiliation(s)
- Nicolaj Mistarz
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark.
| | - Kjeld Andersen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anneke E Goudriaan
- Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research, Department of Research, Arkin, Amsterdam, The Netherlands
| | - Tanja Maria Michel
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Lotte Skøt
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Dorthe Grüner Nielsen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Angelina Isabella Mellentin
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark; Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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26
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Categorising a problem: alcohol and dementia. Acta Neurol Belg 2021; 121:1-10. [PMID: 33052532 DOI: 10.1007/s13760-020-01515-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 12/15/2022]
Abstract
Alcoholism is a chronic relapsing disorder that can include extended periods of abstinence followed by relapse to heavy drinking. Decades of evidence have clearly shown that long-term, chronic ethanol exposure produces brain damage in humans. The article aims to review the relationship between alcohol use and dementia. Medline and Google Scholar searches were conducted for relevant articles, chapters and books published until 2019. Search terms used included alcohol consumption, alcohol-related dementia, alcohol use disorders, chronic alcoholism, dementia. Publications found through this indexed search were reviewed for further relevant references. Alcohol acts on the central nervous system via both direct and indirect effects, frequently a combination of the two. There is consensus that alcohol contributes to the acquisition of cognitive deficits in late life. However, there are doubts regarding the aetiopathogenesis, nosological status and prevalence of alcohol-related dementia and still, there is much debate over how much alcohol consumption will lead to alcohol-related dementia.
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27
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Chou FC, Hsieh KY, Cheng CH, Huang LL, Kao WT, Su CY. Cognitive function and alcohol use disorder: Path analysis for a cross-sectional study in Taiwan. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_25_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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28
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Deterioro cognitivo y recuperación espontánea en pacientes con diagnóstico de Consumo Perjudicial o Síndrome de Dependencia Alcohólico. REVISTA IBEROAMERICANA DE PSICOLOGÍA 2020. [DOI: 10.33881/2027-1786.rip.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
El objetivo de este trabajo era conocer el alcance del deterioro de las funciones cognitivas debido al consumo abusivo de alcohol y su posible recuperación espontánea, así como observar la evolución temporal de esta recuperación, desde el inicio hasta los 24 meses de la abstinencia. Participaron voluntariamente 100 pacientes de ambos sexos, en tratamiento de deshabituación de consumo perjudicial o síndrome de dependencia alcohólico, agrupados en cohortes según tiempo de abstinencia. El grupo control estuvo formado por 20 personas sin antecedentes de alcoholismo, equiparadas con los pacientes en las variables edad, sexo y nivel de estudios. Los datos socio-demográficos y clínicos se recogieron con una anamnesis protocolizada, mientras que para evaluar el deterioro cognitivo se emplearon el Mini-Mental State Examination (MMSE) y el Montreal Cognitive Assessment (MOCA), en sus versiones al español. Para cada participante se obtuvieron 8 variables clínicas y socio-demográficas y 27 variables cognitivas. Se observaron diferencias significativas entre las medidas de las mismas variables cognitivas proporcionadas por ambos instrumentos, siendo más discriminativo el MOCA. Los resultados mostraron que el deterioro y la recuperación espontánea varían para las distintas funciones cognitivas y que los cambios más significativos se dan seis meses después de iniciada la deshabituación y entre los 18 y 24 meses. En base a la evidencia obtenida, atención, memoria y lenguaje se perfilan como las funciones más susceptibles de beneficiarse de un programa de rehabilitación cognitiva, que convendría implementar entre los 6 y 18 meses de abstinencia.
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29
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García-Marchena N, Pizarro N, Pavón FJ, Martínez-Huélamo M, Flores-López M, Requena-Ocaña N, Araos P, Silva-Peña D, Suárez J, Santín LJ, de la Torre R, Rodríguez de Fonseca F, Serrano A. Potential association of plasma lysophosphatidic acid (LPA) species with cognitive impairment in abstinent alcohol use disorders outpatients. Sci Rep 2020; 10:17163. [PMID: 33051508 PMCID: PMC7555527 DOI: 10.1038/s41598-020-74155-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/28/2020] [Indexed: 12/17/2022] Open
Abstract
Lysophosphatidic acid (LPA) species are bioactive lipids participating in neurodevelopmental processes. The aim was to investigate whether the relevant species of LPA were associated with clinical features of alcohol addiction. A total of 55 abstinent alcohol use disorder (AUD) patients were compared with 34 age/sex/body mass index-matched controls. Concentrations of total LPA and 16:0-LPA, 18:0-LPA, 18:1-LPA, 18:2-LPA and 20:4-LPA species were quantified and correlated with neuroplasticity-associated growth factors including brain derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1) and IGF-2, and neurotrophin-3 (NT-3). AUD patients showed dysexecutive syndrome (22.4%) and memory impairment (32.6%). Total LPA, 16:0-LPA, 18:0-LPA and 18:1-LPA concentrations, were decreased in the AUD group compared to control group. Total LPA, 16:0-LPA, 18:2-LPA and 20:4-LPA concentrations were decreased in men compared to women. Frontal lobe functions correlated with plasma LPA species. Alcohol-cognitive impairments could be related with the deregulation of the LPA species, especially in 16:0-LPA, 18:1-LPA and 20:4-LPA. Concentrations of BDNF correlated with total LPA, 18:2-LPA and 20:4-LPA species. The relation between LPA species and BDNF is interesting in plasticity and neurogenesis functions, their involvement in AUD might serve as a biomarker of cognitive impairment.
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Affiliation(s)
- Nuria García-Marchena
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain. .,Institut D, Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Unidad de Adicciones-Servicio de Medicina Interna, Campus Can Ruti, Carrer del Canyet s/n, 08916, Badalona, Spain.
| | - Nieves Pizarro
- Integrative Pharmacology and Systems Neurosciences Research Group, Programa de Investigación en Neurociencias, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Francisco J Pavón
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.,Unidad de Gestión Clínica del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria de Málaga, Malaga, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Miriam Martínez-Huélamo
- Integrative Pharmacology and Systems Neurosciences Research Group, Programa de Investigación en Neurociencias, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Dr. Aiguader 88, 08003, Barcelona, Spain.,Departamento de Nutrición, Ciencias de los Alimentos y Gastronomía, Facultad de Farmacia y Ciencias de los Alimentos, Universidad de Barcelona, Barcelona, Spain
| | - María Flores-López
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
| | - Nerea Requena-Ocaña
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
| | - Pedro Araos
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.,Departamento de Psicobiología y Metodología de las Ciencias del Comportamiento, Instituto de Investigación Biomédica de Málaga (IBIMA), Facultad de Psicología, Universidad de Málaga (UMA), Malaga, Spain
| | - Daniel Silva-Peña
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
| | - Juan Suárez
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
| | - Luis J Santín
- Departamento de Psicobiología y Metodología de las Ciencias del Comportamiento, Instituto de Investigación Biomédica de Málaga (IBIMA), Facultad de Psicología, Universidad de Málaga (UMA), Malaga, Spain
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neurosciences Research Group, Programa de Investigación en Neurociencias, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Dr. Aiguader 88, 08003, Barcelona, Spain.
| | - Fernando Rodríguez de Fonseca
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.
| | - Antonia Serrano
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.
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30
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Caballeria E, Oliveras C, Nuño L, Balcells-Oliveró M, Gual A, López-Pelayo H. A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions. Psychol Med 2020; 50:2113-2127. [PMID: 32840195 DOI: 10.1017/s0033291720002925] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Alcohol-related cognitive impairment (ARCI) is highly prevalent among patients with alcohol dependence. Although it negatively influences treatment outcome, this condition is underdiagnosed and undertreated. The aim of this systematic review is to investigate the existing evidence regarding both cognitive and pharmacological interventions for ARCI. We systematically reviewed PubMed, Scopus and Science direct databases up to May 2019 and followed the PRISMA guidelines. The quality of the studies was assessed using the Jadad Scale. Twenty-six studies were eligible for inclusion (14 referring to neuropsychological interventions and 12 to pharmacological treatments). Among neuropsychological interventions, computerised treatments, errorless learning and component method showed positive effects on working memory, memory measures and general cognitive function. On the other hand, thiamine, memantine and methylphenidate improved working memory, long-term memory and general cognitive function. Nevertheless, these studies have several limitations, such as small sample size, lack of replication of the results or low specificity of the interventions. Therefore, no gold-standard intervention can yet be recommended for clinical practice, and further research based on promising strategies (e.g. digital interventions, thiamine) is required.
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Affiliation(s)
- Elsa Caballeria
- Grup Recerca Addiccions Clínic (GRAC-GRE). Department of Psychiatry, Clinical Institute of Neuroscience, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036Barcelona, Spain
| | - Clara Oliveras
- Grup Recerca Addiccions Clínic (GRAC-GRE). Department of Psychiatry, Clinical Institute of Neuroscience, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036Barcelona, Spain
| | - Laura Nuño
- Grup Recerca Addiccions Clínic (GRAC-GRE). Department of Psychiatry, Clinical Institute of Neuroscience, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036Barcelona, Spain
| | - Mercedes Balcells-Oliveró
- Grup Recerca Addiccions Clínic (GRAC-GRE). Department of Psychiatry, Clinical Institute of Neuroscience, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036Barcelona, Spain
| | - Antoni Gual
- Grup Recerca Addiccions Clínic (GRAC-GRE). Department of Psychiatry, Clinical Institute of Neuroscience, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036Barcelona, Spain
| | - Hugo López-Pelayo
- Grup Recerca Addiccions Clínic (GRAC-GRE). Department of Psychiatry, Clinical Institute of Neuroscience, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170, 08036Barcelona, Spain
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31
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The Modulatory Effect of Metformin on Ethanol-Induced Anxiety, Redox Imbalance, and Extracellular Matrix Levels in the Brains of Wistar Rats. J Mol Neurosci 2020; 70:1943-1961. [PMID: 32621100 DOI: 10.1007/s12031-020-01593-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/13/2020] [Indexed: 01/14/2023]
Abstract
The study investigated the potential neuroprotective effects of metformin (MET) on alcohol-induced neurotoxicity in adult Wistar rats. The animals were randomized in four groups (n = 10): control, alcohol (ALC), ALC + MET, and MET. ALC (2 g/kg b.w.) and MET (200 mg/kg b.w.) were orally administered for 21 days, once daily. For the ALC + MET group, MET was administered 2 h after ALC treatment. On day 22, the open field test (OFT) and elevated plus maze (EPM) were performed. MET improved global activity and increased the time spent in unprotected open arms, decreased oxidative stress, both in the frontal lobe and in the hippocampus, and increased neuroglobin expression in the frontal cortex. Histopathologically, an increased neurosecretory activity in the frontal cortex in the ALC + MET group was noticed. Thus, our findings suggest that metformin has antioxidant and anxiolytic effects and may partially reverse the neurotoxic effects induced by ethanol.
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Clergue-Duval V, Questel F, Azuar J, Paquet C, Cognat E, Amami J, Queneau M, Dereux A, Barré T, Bellivier F, Farid K, Vorspan F. Brain 18FDG-PET pattern in patients with alcohol-related cognitive impairment. Eur J Nucl Med Mol Imaging 2019; 47:281-291. [DOI: 10.1007/s00259-019-04487-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
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Role of Patient Sex in Early Recovery from Alcohol-Related Cognitive Impairment: Women Penalized. J Clin Med 2019; 8:jcm8060790. [PMID: 31167412 PMCID: PMC6617550 DOI: 10.3390/jcm8060790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/13/2019] [Accepted: 05/31/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The objective was to explore the role of patient sex in cognitive recovery and to identify predictive factors for non-recovery in alcohol use disorder (AUD). METHODS All patients with AUD admitted to a residential addictions treatment center were systematically assessed at admission and after 6 weeks of abstinence in a controlled environment. The inclusion criteria were that patients were admitted for AUD with baseline alcohol-related cognitive impairment (baseline total Montreal Cognitive Assessment (MoCA) score < 26) and reassessed at 6 weeks (n = 395). A logistic regression model was built to determine the influence of sex on recovery status (MoCA < or ≥ 26) taking into account the interaction effect of sex with alcohol consumption on cognitive function. RESULTS The mean age was 50.10 years (SD = 9.79), and 27.41% were women. At baseline, the mean MoCA scores were 21.36 (SD = 3.04). Participants who did not achieve recovery (59.3% of women vs 53.8% of men) had lower total MoCA scores at baseline. The 2 factors that was significantly and independently associated with non-recovery and with a non-zero coefficient was being a woman and initial MoCA score (respective adjusted odds ratios (AOR) = 1.5 and 0.96, p-values < 0.05). CONCLUSIONS These results could influence the time required in a controlled environment to maintain abstinence and the duration of in-care for women.
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Haalboom R, van Aken L, Walvoort SJW, Egger JIM, Kessels RPC. Preserved intellectual functioning in Korsakoff’s syndrome? Actual and premorbid intelligence in patients with major or mild alcohol-related cognitive disorder. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1619101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rhody Haalboom
- Thalamus Centre for Outpatient Neuropsychiatry, Pro Persona, Wolfheze, The Netherlands
| | - Loes van Aken
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Serge J. W. Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Jos I. M. Egger
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
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Abstract
LEARNING OBJECTIVES After participating in this activity, learners should be better able to:• Characterize cognitive dysfunction in patients with major depressive disorder.• Evaluate approaches to treating cognitive dysfunction in patients with major depressive disorder. ABSTRACT Cognitive dysfunction is a core psychopathological domain in major depressive disorder (MDD) and is no longer considered to be a pseudo-specific phenomenon. Cognitive dysfunction in MDD is a principal determinant of patient-reported outcomes, which, hitherto, have been insufficiently targeted with existing multimodal treatments for MDD. The neural structures and substructures subserving cognitive function in MDD overlap with, yet are discrete from, those subserving emotion processing and affect regulation. Several modifiable factors influence the presence and extent of cognitive dysfunction in MDD, including clinical features (e.g., episode frequency and illness duration), comorbidity (e.g., obesity and diabetes), and iatrogenic artefact. Screening and measurement tools that comport with the clinical ecosystem are available to detect and measure cognitive function in MDD. Notwithstanding the availability of select antidepressants capable of exerting procognitive effects, most have not been sufficiently studied or rigorously evaluated. Promising pharmacological avenues, as well as psychosocial, behavioral, chronotherapeutic, and complementary alternative approaches, are currently being investigated.
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Pillon SC, Vedana KGG, Teixeira JA, Dos Santos LA, de Souza RM, Diehl A, Rassool GH, Miasso AI. Depressive symptoms and factors associated with depression and suicidal behavior in substances user in treatment: Focus on suicidal behavior and psychological problems. Arch Psychiatr Nurs 2019; 33:70-76. [PMID: 30663628 DOI: 10.1016/j.apnu.2018.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 10/23/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
Abstract
AIM To investigate the prevalence of depressive symptoms, psychological problems, suicidal behaviour and their associations in substance users in treatment. METHODS A cross-sectional study, with 307 substance users in an out-patient treatment facility, was undertaken. Socio-demographic data, psychoactive substances used, depressive symptoms, and suicide information were obtained. RESULTS 70% of participants were depressed; of those, 8.1% were either under the influence of drugs or in withdrawal. Suicidal ideation was found to be present in those who had anxiety, were nervous, had depressive symptoms, or were under drug influence or in withdrawal. CONCLUSION It is important to identify potential suicidal risk factors and implement the management of these conditions in substance users.
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Affiliation(s)
- Sandra Cristina Pillon
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil.
| | - Kelly Graziani Giacchero Vedana
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil.
| | - Jessica Adrielle Teixeira
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil
| | | | - Roberto Molina de Souza
- Federal Technological University of Paraná, Brazil; Academic Department of Mathematics (DAMAT), Cornélio Procópio, Paraná, Brazil
| | - Alessandra Diehl
- Federal University of São Paulo (UNIFESP), Psychiatric Department, Brazil
| | | | - Adriana Inocenti Miasso
- University of São Paulo (USP), Psychiatric Nursing and Human Science Department, Faculty of Nursing at Ribeirão Preto (EERP), Brazil; PAHO/WHO Collaborating Centre for Nursing Research Development, Brazil.
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Heirene R, John B, Roderique-Davies G. Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review. Front Psychol 2018; 9:2618. [PMID: 30619013 PMCID: PMC6305333 DOI: 10.3389/fpsyg.2018.02618] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/05/2018] [Indexed: 12/27/2022] Open
Abstract
Background: Neuropsychological assessment is central to identifying and determining the extent of Alcohol-Related Cognitive Impairment (ARCI). The present systematic review aimed to synthesize and discuss the evidence appraising the neuropsychological tests used to assess ARCI in order to support clinicians and researchers in selecting appropriate tests for use with this population. Methods: We searched for studies investigating the psychometric, diagnostic and practical values of tools used in the screening, diagnosis, and assessment of Korsakoff's Syndrome (KS), Alcohol-Related Dementia (ARD), and those with a specific diagnosis of Alcohol-Related Brain Damage (ARBD). The following databases were searched in March 2016 and again in August 2018: MEDLINE, EMBASE, Psych-INFO, ProQuest Psychology, and Science Direct. Study quality was assessed using a checklist designed by the authors to evaluate the specific factors contributing to robust and clearly reported studies in this area. A total of 43 studies were included following the screening of 3646 studies by title and abstract and 360 at full-text. Meta-analysis was not appropriate due to heterogeneity in the tests and ARCI samples investigated in the studies reviewed. Instead, review findings were narratively synthesized and divided according to five domains of assessment: cognitive screening, memory, executive function, intelligence and test batteries, and premorbid ability. Effect sizes (d) were calculated to supplement findings. Results: Overall, several measures demonstrated sensitivity to the cognitive deficits associated with chronic alcoholism and an ability to differentiate between gradations of impairment. However, findings relating to the other psychometric qualities of the tests, including those important for the accurate assessment and monitoring of ARCI (e.g., test-retest reliability), were entirely absent or limited. Additionally, the synthesis of neuropsychological outcomes presented here supports the recent impetus for a move away from discrete diagnoses (e.g., KS, ARD) and the distinctions between them toward more broad and inclusive diagnostic conceptualizations of ARCI, thereby recognizing the heterogeneity in presentation. Conclusions: Based on the evidence reviewed, provisional recommendations for appropriate tests in each domain of assessment are presented, though further validation of most tests is warranted. Review findings can support efficient and evidenced-based test-selection and guide future research in this area.
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Affiliation(s)
- Robert Heirene
- Addictions Research Group, University of South Wales, School of Psychology & Therapeutic Studies, Pontypridd, United Kingdom
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Johnson JM, Fox V. Beyond Thiamine: Treatment for Cognitive Impairment in Korsakoff’s Syndrome. PSYCHOSOMATICS 2018; 59:311-317. [DOI: 10.1016/j.psym.2018.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 12/20/2022]
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