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Ishikawa M, Mori E. Association of gait and cognition after surgery in patients with idiopathic normal pressure hydrocephalus. Sci Rep 2023; 13:18460. [PMID: 37891211 PMCID: PMC10611736 DOI: 10.1038/s41598-023-45629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/21/2023] [Indexed: 10/29/2023] Open
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a treatable disease in older adults. The association between gait and cognition has recently become a topic of interest. Sequential changes in this association were investigated in patients with iNPH using a newly developed statistical method. Data were extracted from the SINPHONI-2 multicenter study on iNPH. Fifty patients who underwent shunt surgery were included in this study. Gait and cognition were assessed using the Timed Up and Go (TUG) and Mini-Mental State Examination (MMSE) tests. In addition to the MMSE total score, changes in the sub-item scores were examined. The ordinal sub-items of the MMSE are usually treated as continuous or categorical; however, both are unsuitable. An ordinal smoothing penalty with a generalized additive model enables precise statistical inference of ordinal and binary predictors. The TUG time improved significantly at 3, 6, and 12 months after surgery. The MMSE total scores increased without statistical significance. Preoperatively, there was no association between TUG time and MMSE sub-items. At 3 months, the "Registration," "3-step command," "Read," and "Copy" sub-items were statistically significant. The number of significant sub-items increased after 12 months. Thus, the association between gait and cognition gradually increased after surgery in patients with iNPH.
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Affiliation(s)
- Masatsune Ishikawa
- Rakuwa Villa Ilios, Kyoto, Kyoto, Japan.
- Normal Pressure Hydrocephalus Center, Otowa Hospital, Kyoto, Kyoto, Japan.
| | - Etsuro Mori
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate, Toyonaka, Osaka, Japan
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Bell T, Pope C, Fazeli P, Crowe M, Ball K. The Association of Persistent Low Back Pain With Older Adult Falls and Collisions: A Longitudinal Analysis. J Appl Gerontol 2020; 40:1455-1464. [PMID: 33095077 DOI: 10.1177/0733464820966517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mobility-related injuries associate with reduced quality of life, greater functional dependence, and quicker mortality in older adults-warranting prevention efforts. One factor elevating injury risk may be persistent low back pain, which can negatively affect cognitive and physical functions essential for safe mobility. Among older adults obtaining license renewal (n = 1,127), this study examined the association between persistent low back pain and incidence of falls and motor vehicle collisions (MVCs) for up to 15 years. Overall, older adults with persistent low back pain were more likely to have a fall (odds ratio [OR] = 1.54, 95% confidence interval [CI] = [1.34, 1.77]) or MVC (OR = 1.38, 95% CI = [1.07, 1.77]) than those without back pain. Furthermore, the number of falls and MVCs was lower for people with better lower limb and visuospatial function, respectively. Ameliorating pain and functioning in persistent lower back pain might contribute to improved mobility and a reduction of injury-related risk in later life.
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Delpak A, Talebi M. On the impact of age, gender and educational level on cognitive function in Alzheimer’s disease: A quantitative approach. Arch Gerontol Geriatr 2020; 89:104090. [DOI: 10.1016/j.archger.2020.104090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/09/2020] [Accepted: 04/26/2020] [Indexed: 11/27/2022]
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Han G, Maruta M, Ikeda Y, Ishikawa T, Tanaka H, Koyama A, Fukuhara R, Boku S, Takebayashi M, Tabira T. Relationship between Performance on the Mini-Mental State Examination Sub-Items and Activities of Daily Living in Patients with Alzheimer's Disease. J Clin Med 2020; 9:E1537. [PMID: 32443659 PMCID: PMC7291070 DOI: 10.3390/jcm9051537] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022] Open
Abstract
Mini-mental state examination (MMSE) subitems provide useful information about the cognitive status of patients with Alzheimer's disease (AD). If the relationship between MMSE subitems and activities of daily living (ADL) can be shown, the performance of sub-items can predict ADL status and may provide useful information for early ADL intervention. Therefore, the purpose of this study was to investigate the relationship between MMSE subitem scores and ADL. The study sample consisted of 718 patients with AD. Logistic regression analysis using the Physical Self-maintenance Scale (PSMS) and Lawton's Instrumental ADL (L-IADL) was performed with each of the subitems as the dependent variables and the MMSE subitem as the independent variable. As a result, the subitems of MMSE, which are strongly related to each item in PSMS differed (e.g., toilet: registration odds ratio 3.00, grooming: naming 3.66). In the case of L-IADL, most items were strongly associated with "writing" (e.g., shopping: odds ratio 4.29, laundry 3.83). In clinical practice, we often focus only on the total MMSE score in patients with AD. However, the relationship between each MMSE subitem and ADL suggested in this study may be useful information that can be linked to ADL care from the performance of the MMSE subitem.
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Affiliation(s)
- Gwanghee Han
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan;
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto 860-8556, Japan; (T.I.); (H.T.); (R.F.); (S.B.); (M.T.)
| | - Michio Maruta
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan;
- Department of Rehabilitation, Medical Corporation Sanshukai, Okatsu Hospital, Kagoshima 890-0067, Japan
| | - Yuriko Ikeda
- Department of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan;
| | - Tomohisa Ishikawa
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto 860-8556, Japan; (T.I.); (H.T.); (R.F.); (S.B.); (M.T.)
| | - Hibiki Tanaka
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto 860-8556, Japan; (T.I.); (H.T.); (R.F.); (S.B.); (M.T.)
| | - Asuka Koyama
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan;
| | - Ryuji Fukuhara
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto 860-8556, Japan; (T.I.); (H.T.); (R.F.); (S.B.); (M.T.)
| | - Shuken Boku
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto 860-8556, Japan; (T.I.); (H.T.); (R.F.); (S.B.); (M.T.)
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan;
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto 860-8556, Japan; (T.I.); (H.T.); (R.F.); (S.B.); (M.T.)
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan;
- Division of Psychiatry and Neuroscience, Institute for Clinical Research, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Hiroshima 737-0023, Japan
| | - Takayuki Tabira
- Department of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima 890-8544, Japan;
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Carotid artery plaque detected on ultrasound is associated with impaired cognitive state in the elderly: A population-based study in Wakiso district, Uganda. J Clin Neurosci 2019; 68:194-200. [PMID: 31301929 DOI: 10.1016/j.jocn.2019.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 02/01/2019] [Accepted: 06/09/2019] [Indexed: 12/24/2022]
Abstract
Carotid artery disease which includes carotid artery stenosis, plaques, clots and increased intima media thickness, have been reported by many studies to be associated with dementia. Dementia is an end stage of usually asymptomatic cognitive impairment. Risk factors of carotid artery disease include; age, atherosclerosis, arteriosclerosis, shorter years in school, history of hypertension, diabetes mellitus, stroke and depression. This study set out to determine the prevalence of abnormal carotid ultrasound findings and their association with cognitive function among the adults ≥60 years in Wakiso district, Uganda in 2018. A total of 210 participants were included. Carotid artery stenosis, presence of plaque, stenosis and intima-media thickness were assessed by ultrasound. Cognitive status was assessed using a Mini Mental State Exam (MMSE) test. The prevalence of plaque was 21.4%. Variables which included; presence of plaque, age, education, gender, marital status, whether participant stayed alone or with someone else, care for self, occupation status, division of staying and history of smoking. The presence of plaque was associated with an abnormal cognitive function at both univariate and multivariate analysis with respective OR = 3.8 (95% CI = 1.90-7.54, p-value = 0.0001) and OR = 3.4 (95% CI = 1.38-8.15, p-value = 0.007). The cognitive function distribution was 43.8%, 19%, 34.3% and 2.9% within the normal, mild, moderate, and severe cognitive function status respectively. This study showed that prevalence of carotid artery plaque was high in this elderly population in Wakiso district Uganda. Also, carotid artery plaque was associated with abnormal cognitive function.
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