Background:Cognitive assessments,such as the Montreal Cognitive Assessment(MoCA),use components that assume intact sensory abilities,however,adults show concomitant decreases in visual acuity with increasing age.Score...Background:Cognitive assessments,such as the Montreal Cognitive Assessment(MoCA),use components that assume intact sensory abilities,however,adults show concomitant decreases in visual acuity with increasing age.Scores on cognitive assessments are typically lower for individuals with visual impairments compared to individuals with normal/corrected to normal vision.But it is not clear if lowers scores on cognitive assessments are due to the assessments relying on visual stimuli,or if individuals with visual impairments are actually more likely to have cognitive impairments.Therefore we simulated visual impairments,i.e.,reduced visual acuity and contrast sensitivity,in young healthy adults to determine how this impacts their scores on a measure of cognitive ability,i.e.,the MoCA.Methods:Participants(n=19)completed one of the three version of the MoCA under three conditions(20/20,simulated 20/80,simulated 20/200).The MoCA was administered following the clinical protocols.Only participants that scored>26(i.e.,normal cognitive function)at 20/20 were included in the analysis.For comparison,we included MoCA data from a sample of older adults with normal vision(n=19,Mage=74,Acuity M=0.04 logMAR,SD=0.16)or visual impairment(n=19,Mage=79,Acuity M=0.35 logMAR,SD=0.3).Results:Acuity of participants at 20/20(M=0.06 LogMAR,SD=0.1),simulated 20/80(M=0.63,SD=0.18)and simulated 20/200(M=0.88,SD=0.19)showed that the participants experienced simulated acuity loss with the goggles.For the MoCA scores,we found a main effect of acuity(F=16.22,P<0.001,η2=0.375,BF10=5,618).Planned post hoc comparisons showed a significant difference between scores with a 20/20 acuity(M=27.26,SD=0.93)and 20/80(M=24.74,SD=1.66,t=5.62,ptukey<0.001,d=1.88),and between 20/20 and 20/200(M=25.63,SD=1.46,t=3.63,ptukey=0.002,Cohen’s d=1.33).However,no difference was observed between 20/80 and 20/200(t=−1.99,ptukey=0.125,d=0.572).The MoCA scores in older adults with normal vision(M=27.32,SD=2.41)and with visual impairment(M=26.68,SD=2.52),did not differ significantly(t36=−0.787,P=0.436,d=0.26,BF10=0.4).Conclusions:Our findings show that simulated reductions in visual acuity and contrast sensitivity lead to lower scores on measures of cognitive ability,specifically the MoCA.However,it appears that older adults with actual visual impairments may have developed compensatory strategies to adapt to this loss in visual acuity as there were no significant differences in scores of older adults with and without visual impairments.Therefore,we would recommend that when assessing an individual with visual impairments to conduct the cognitive test by re-scoring it without the visual components,e.g.,the MoCA Blind,to magnify the visual components,or to substitue the visual component when possible using auditory alternatives,e.g.,the oral trail making task.展开更多
[Purpose] This study aimed to evaluation of the Tokyo cognitive assessment (Toca) for predicting cognitive impairment in rehabilitation users. [Method] The variables of age, BMI, educational background, Toca for 36 re...[Purpose] This study aimed to evaluation of the Tokyo cognitive assessment (Toca) for predicting cognitive impairment in rehabilitation users. [Method] The variables of age, BMI, educational background, Toca for 36 rehabilitation users and 22 healthy elder were assessed. We compared cognitive functions in rehabilitation users who need support and healthy elders. [Results] Of the Toca 1 to 11 trials, there was a significant difference other than 9, 10 rials. The Toca scores with 8 points higher were significantly higher in healthy elders than in rehabilitation users. The area under the receiver-operator curve (AUC) for predicting mild cognitive impairment (MCI) by the Toca was 0.874. Using a cut-off point of 19/20, the Toca demonstrated a sensitivity of 83.9% and a sensitivity of 85.0% in diagnosing MCI. [Conclusion] The Toca is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in rehabilitation users.展开更多
BACKGROUND The role of comprehensive geriatric assessment(CGA)in screening for mild cognitive disorders was not known.AIM To evaluate the role of CGA in screening for mild cognitive disorders.METHODS A total of 100 el...BACKGROUND The role of comprehensive geriatric assessment(CGA)in screening for mild cognitive disorders was not known.AIM To evaluate the role of CGA in screening for mild cognitive disorders.METHODS A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis.Using Petersen as the diagnostic gold standard,healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group.The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed.Patients'Montreal Cognitive Assessment(MoCA)and CGA screening results were compared,and the sensitivity and specificity were calculated to assess the screening role of CGA.RESULTS CGA assessment yielded higher diagnostic accuracy than MoCA.The results of the multivariate regression analysis showed no correlation of gender,age,body mass index and literacy with cognitive function.Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals(P<0.05).In the CGA scale,patients with mild cognitive impairment showed significantly lower Mini-mental State Examination,Miniature Nutritional Assessment and Berg Balance Scale scores,and higher Activity of Daily Living,Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals(P<0.05),whereas the other assessment scales showed no significant differences(P>0.05).The CGA provides higher diagnostic sensitivity and specificity than the MoCA(P<0.05).CONCLUSION CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity,facilitating timely and effective intervention,and is thus recommended for clinical use.展开更多
This study explored the construction of power relations in the cognitive assessment of older adults within the Chinese clinical context.Data is derived from audio and video recordings that nine older adults produced i...This study explored the construction of power relations in the cognitive assessment of older adults within the Chinese clinical context.Data is derived from audio and video recordings that nine older adults produced in the cognitive assessment of the Chinese version of the Montreal Cognitive Assessment-Basic(MoCA-B),which were then annotated and analyzed from a multimodal pragmatic perspective.The study reveals that examiners and older adults employed various speech acts to achieve distinct communicative goals,with power relations between them being reflected through these speech acts.Examiners tend to claim high power,utilizing discourse strategies such as request,interruption,evaluation,rhetorical questions,and directive speech acts.In contrast,older adults assert high power through directive speech acts,rhetorical questions,and interruptions.Both parties also exhibit low power by using confirming questions and explanations.Additionally,gestures,smiles,prosody features,and other non-verbal communicative resources are synergistically employed to exercise power.The interactive mechanism of constructing power relations reveals that age affects older adults’power relations construction even in a professional setting of the Chinese context.The negotiation between the advanced age of older adults and the expertise of examiners jointly shapes power relations in their interactions.展开更多
Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects a...Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).展开更多
Background： Nonlinguistic cognitive impairment has become an important issue for aphasic patients, but currently there are few neuropsychological cognitive assessment tests for it. To get more information on cognitiv...Background： Nonlinguistic cognitive impairment has become an important issue for aphasic patients, but currently there are few neuropsychological cognitive assessment tests for it. To get more information on cognitive impairment of aphasic patients, this study aimed to develop a new cognitive assessment test battery for aphasic patients, the Non-language-based Cognitive Assessment （NLCA）, and evaluate its utility in Chinese-speaking patients with aphasia. Methods： The NLCA consists of five nonverbal tests, which could assess five nonlinguistic cognitive domains such as visuospatial functions, attention test, memory, reasoning, and executive functions of aphasic patients. All tests are modified from the nonverbal items of the current existed tests with some changes to the characteristics of Chinese culture. The NLCA was tested in 157 participants （including 57 aphasic patients, 50 mild cognitive impairment （MCI） patients, and 50 normal controls）, and was compared with other well-established relative neuropsychological tests on the reliability, validity, and utility. Results： The NLCA was fully applicable in the MCI patients and the normal controls, almost working in the aphasic patients （57/62 patients, 91.9%）. The NLCA scores were 66.70± 6.30, 48.67± 15.04, and 77.58±2.56 for the MCI group, the aphasic group, and the control group, respectively , and a significant difference was found among three groups （F = 118.446, P 〈 0.001）. The Cronbach＇s alpha of the NLCA as an index of internal consistency was 0.805, and the test-retest and interrater reliability was adequate （r=0.977 and r= 0.970, respectively）. The correlations of the cognitive subtests and their validation instruments were between 0.540 and 0.670 （all P 〈 0.05）. Spearman＆#39;s correlation analysis indicated that the coefficient of internal consistency of each subtest itself was higher than other subtests.When choosing the Montreal Cognitive Assessment score of 〈26 as the diagnostic criteria of cognitive impairment, the area under the curve for all participants in the control and MCI groups was 0.942 （95% confidence interval： 0.895–0.989）, and an optimal cutoff point of 75.00 seemed to provide the best balance between sensitivity and specificity. Age （r = -0.406, P 〈 0.001） was the main influence factor for the NLCA. Conclusions： The NLCA could efficiently differentiate the cognitive impairment patients from the normal controls and is a reliable and valid cognitive assessment test battery to specially find nonlinguistic cognitive function for aphasic patients.展开更多
Purpose： To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment （MoCA） and Mini-Mental State Examination （MMSE） in patients with chronic traumatic brain injury （TBI） or stroke...Purpose： To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment （MoCA） and Mini-Mental State Examination （MMSE） in patients with chronic traumatic brain injury （TBI） or stroke and to evaluate the sensitivity of the two scales in patients with TBI. Methods： In this cohort study, a total of 230 patients were evaluated, including TBI group （n = 103） and stroke group （n - 127）. The cognitive functions of two groups were evaluated by designated specialists using MoCA （Beijing version） and MMSE （Chinese version）. Results： Compared with the patients with stroke, the patients with TBI received significantly lower score in orientation subtest and recall subtest in both tests. MoCA abnormal rates in the TBI group and stroke group were 94.17% and 86.61% respectively, while MMSE abnormal rates were 69.90% and 57.48%, respectively. In the TBI group, 87.10% patients with normal MMSE score had abnormal MoCA score and in the stroke group, about 70.37% patients with normal MMSE score had abnormal MoCA score. The diagnostic consistency of two scales in the TBI group and the stroke group were 72% and 69%, re.spectively. Conclusion： In our rehabilitation center, patients with TBI may have mare extensive and severe cognitive impairments than patients with stroke, prominently in orientation and recall domain. In screening post- TBI cognitive impairment, MoCA tends to be more sensitive than MIV[SE.展开更多
Cognitive decline in Parkinson’s disease (PD) is defined as dementia which affects activities of daily living (ADL) function. Dementia is one of the recognized issues in the treatment of Parkinson’s disease patients...Cognitive decline in Parkinson’s disease (PD) is defined as dementia which affects activities of daily living (ADL) function. Dementia is one of the recognized issues in the treatment of Parkinson’s disease patients (PDP) as it is becoming a major contributor to morbidity. The objective of our study was to evaluate the cognitive decline in Parkinson’s disease patients (PDP) and the influence of cognition on daily living function deterioration in cognitively impaired and cognitively unimpaired PDP. Cognitively impaired PDP (n = 24), and cognitively unimpaired PDP (n = 16) were administered MoCA and MMSE performance based tests for cognitive measurements and Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL) to determine everyday functioning. The significances of MoCA and MMSE among cognitively impaired PDP and cognitively unimpaired PDP in univariant analysis were P < 0.001 and P < 0.05. In partial correlation, MoCA was strongly related to ADL function as compare to MMSE (r = 0.623, P = 0.001). Cognitively impaired PDP showed significantly lower score on visuo-construction and attention. Among all variables of MoCA domains, attention is strongly associated with instrumental activity daily living (IADL) scores (logistic regression coefficient = 0.672, P = 0.01). These results suggest that dementia affects daily living performances especially the IADL tasks like attention and execution. Therefore, the assessment of complex daily activities particularly IADL is probably useful for the diagnosis of early stage cognitive impairment in PDP. Further MMSE test is less sensitive than MoCA for detecting significant cognitive decline in PDP and impaired attention is an important determinant of ADL functions in cognitively impaired PDP.展开更多
Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) a...Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) and preclinical AD determined by Aβ load using PET. The goal of this study was to compare a new computerized version of the LASSI-L (LASSI-Brief Computerized) to the standard paper-and-pencil version of the test. In this study, we examined 110 cognitively unimpaired (CU) older adults and 79 with amnestic MCI (aMCI) who were administered the paper-and-pencil form of the LASSI-L. Their performance was compared with 62 CU older adults and 52 aMCI participants examined using the LASSI-BC. After adjustment for covariates (degree of initial learning, sex, education, and language of evaluation) both the standard and computerized versions distinguished between aMCI and CU participants. The performance of CU and aMCI groups using either form was relatively commensurate. Importantly, an optimal combination of Cued B2 recall and Cued B1 intrusions on the LASSI-BC yielded an area under the ROC curve of .927, a sensitivity of 92.3% and specificity of 88.1%, relative to an area under the ROC curve of .815, a sensitivity of 72.5%, and a specificity of 79.1% obtained for the paper-and-pencil LASSI-L. Overall, the LASSI-BC was comparable, and in some ways, superior to the paper-and-pencil LASSI-L. Advantages of the LASSI-BC include a more standardized administration, suitability for remote assessment, and an automated scoring mechanism that can be verified by a built-in audio recording of responses.展开更多
BACKGROUND Post-stroke cognitive impairment(PSCI)is not only a common consequence of stroke but also an important factor for adverse prognosis of patients.Biochemical indicators such as blood lipids and blood pressure...BACKGROUND Post-stroke cognitive impairment(PSCI)is not only a common consequence of stroke but also an important factor for adverse prognosis of patients.Biochemical indicators such as blood lipids and blood pressure are affected by many factors,and the ability of evaluating the progress of patients with PSCI is insufficient.Therefore,it is necessary to find sensitive markers for predicting the progress of patients and avoiding PSCI.Recent studies have shown thatβ-amyloid protein 1-42(Aβ1-42)and thyroid hormone levels are closely related to PSCI,which may be the influencing factors of PSCI,but there are few related studies.AIM To investigate the relationship between serum levels of Aβand thyroid hormones in acute stage and PSCI and its predicted value.METHODS A total of 195 patients with acute cerebral infarction confirmed from June 2016 to January 2018 were enrolled in this study.Baseline data and serological indicators were recorded to assess cognitive function of patients.All patients were followed up for 1 year.Their cognitive functions were evaluated within 1 wk,3 mo,6 mo and 1 yr after stroke.At the end of follow-up,the patients were divided into PSCI and non-PSCI according to Montreal cognitive assessment score,and the relationship between biochemical indexes and the progression of PSCI was explored.RESULTS Compared with patients with non-PSCI,the levels of Aβ1-42,triiodothyronine(T3)and free thyroxin were lower in the patients with PSCI.Repeated measures analysis of variance showed that the overall content of Aβ1-42 and T3 in PSCI was also lower than that of the non-PSCI patients.Further analysis revealed that Aβ1-42(r=0.348),T3(r=0.273)and free thyroxin(r=0.214)were positively correlated with disease progression(P<0.05),suggesting that these indicators have the potential to predict disease progression and outcome.Cox regression analysis showed that Aβ1-42 and T3 were important factors of PSCI.Then stratified analysis showed that the lower the Aβ1-42 and T3,the higher risk of PSCI in patients who were aged over 70,female and illiterate.CONCLUSION Aβ1-42 and T3 have the ability to predict the progression of PSCI,which is expected to be applied clinically to reduce the incidence of PSCI and improve the quality of life of patients.展开更多
Patients with mild cognitive impairment after a transient ischemic attack were included in this study. They were treated with Yizhi Xingnao prescription, ergoloid mesylates or aspirin for 60 days. Evaluation using the...Patients with mild cognitive impairment after a transient ischemic attack were included in this study. They were treated with Yizhi Xingnao prescription, ergoloid mesylates or aspirin for 60 days. Evaluation using the Montreal Cognitive Assessment Scale showed that cognitive function was significantly improved in all patients, especially after the combined treatment of Yizhi Xingnao and aspirin. The scores from the Montreal Cognitive Assessment Scale were improved overall and the effective treatment rate was as high as 79%, which was higher than patients treated with a combination of ergoloid mesylates and aspirin, or aspirin alone. Our experimental findings indicate that YizhiXingnao prescription can improve mild cognitive impairment after a transient ischemic attack, and that it is more effective than ergoloid mesylates.展开更多
The current pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly referred to as COVID-19, brings myriad challenges to research conducted among those more susceptible to the virus. Accordi...The current pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly referred to as COVID-19, brings myriad challenges to research conducted among those more susceptible to the virus. According to the United States (US) Centers for Disease Control (CDC), eight out of ten re-ported COVID-19 deaths are among people > 65 years of age and older. Nonetheless, researchers must continue the crucial work of investigating and understanding diseases that affect the elderly. The focus of this white paper is to assess the challenges associated with research within the elderly population with neurocognitive conditions. Specifically, this paper addresses the need for the standardized administration of performance measures (e.g., neurocognitive assessments) among a dementia population while ensuring the physical safety of participants. Consideration is given to the administration of performance measures and the availability and feasibility of administering these measures remotely to a population that may have difficulty using novel technologies. In implementing remote research assessments, it is suggested that researchers fol-low a GAMMA approach by: 1) establishing clear Guidance on remote visit expectations and processes;2) establishing Appropriate exclusionary criteria in the development of the study design;3) providing subjects Appropriate study Materials for visual processing;4) incorporating Multiple data sources in the overall study design (e.g., caregiver input);and 5) Acknowledging that there will be study limitations as researchers use emerging technology with this patient population, and using mitigation strategies for these limitations where possible.展开更多
BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant wo...BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus(GDM).METHODS The study subjects were divided into three groups:GDM group(n=81),healthy pregnant(HP)group(n=85),and control group(n=51).The Montreal Cognitive Assessment(MoCA)was used to assess the cognitive status of each group.Venous blood samples were collected to measure blood lipids,glycated hemoglobin,and glucose levels.For each participant,a 3-mL blood sample was collected and centrifuged,and the serum was collected.Blood samples were stored at-80℃,and DPP4,interleukin-6(IL-6),and 8-iso-prostaglandin F2α(8-iso-PGF2α),and brain-derived neurotrophic factor(BDNF)were detected using ELISA.RESULTS The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention(P<0.05);however,the scores were not significantly different between the GDM and HP groups(P>0.05).In terms of language,the GDM group had significantly different scores from those in the other two groups(P<0.05).In terms of memory,a significant difference was found between the HP and control groups(P<0.05),as well as between the GDM and HP groups.The levels of DPP4,IL-6,and 8-iso-PGF2αin the GDM group were significantly higher than those in the HP and control groups(P<0.05);however,the differences between these levels in the HP and control groups were not significant(P>0.05).The level of BDNF in the GDM group was significantly lower than that in the HP and control groups(P<0.05),although the difference in this level between the HP and control groups was not significant(P>0.05).CONCLUSION Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss,which might be associated with elevated DPP4 levels.展开更多
Purpose: To investigate whether long-term noise exposure affects the cognitive ability of grinders. Methods: Cumulative noise exposure (CNE) and LAeq.8h determination were used to characterize the level of individual ...Purpose: To investigate whether long-term noise exposure affects the cognitive ability of grinders. Methods: Cumulative noise exposure (CNE) and LAeq.8h determination were used to characterize the level of individual noise exposure;the Montreal Cognitive Assessment (MoCA) test (Beijing version) was used to evaluate cognitive function. Results: We compared the basic situation of workers in different groups and individual noise exposure intensity of grinders was monitored. Multiple linear-regression analysis was made and score of MoCA in different group was finally drawn. Conclusion: CNE and total score of MoCA have the relationship of negative correlation (r = -0.303, p < 0.05) which means long-term occupational noise exposure can affect the cognitive ability of grinders.展开更多
It is very important to study the factors affecting the incidence,progress and prognosis of patients with vascular dementia.50 cases of severe middle cerebral artery stenosis or occlusion underwent endovascular treatm...It is very important to study the factors affecting the incidence,progress and prognosis of patients with vascular dementia.50 cases of severe middle cerebral artery stenosis or occlusion underwent endovascular treatment(25 cases of mild cognitive dysfunction,25 cases of moderate cognitive dysfunction)were divided into two groups,where a medical drug treatment group and a control group established with 25 cases in each group.The cognitive function of each group of patients was evaluated before operation,7 days after operation,30 days after operation,and 180 days after operation.CTP was used to compare the hemodynamic changes in patients before and after operation.The severe stenosis or occlusion of the middle cerebral artery in patients can be improved,and the intracranial blood supply of patients with poorly compensated medial cranial circulation and hypoperfusion can be restored to a certain extent.Meanwhile,improvement of cognitive function was definitive in some patients with cognitive dysfunction.To guide the formulation of treatment plans for patients with severe middle cerebral artery stenosis or occlusion.展开更多
AIM:To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia(ATD)using optical coherence tomography angiography(OCTA),to record flash electroretinograms(ERG)using the RETeval system and...AIM:To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia(ATD)using optical coherence tomography angiography(OCTA),to record flash electroretinograms(ERG)using the RETeval system and to explore changes in retinal function.METHODS:Twenty-nine patients with ATD and 26 age-matched normal subjects were enrolled.All subjects underwent OCTA scans to analyse the superficial retinal vessel parameters in the macular area,including the vessel length density,the vessel perfusion density and the area of foveal avascular zone(FAZ),as well as the choroidal thickness.The differences between the patients with ATD and the normal control group were compared and explored the relevant factors affecting vessel parameters.We also recorded the flash ERGs using the RETeval system and intended to explore changes in retinal function by analysing the ERG image amplitude in patients with ATD.RESULTS:The vessel parameters[Pvessel length density=0.005 and Pvessel perfusion density=0.006]and average choroid thickness(P<0.001)in the macular area of the ATD group was less than the control group.The FAZ area was statistically significantly enlarged in the ATD group(P<0.001).These parameters were correlated with the Mini-Mental State Examination(MMSE)score and the Montreal Cognitive Assessment(MoCA).CONCLUSION:Patients with ATD exhibit decreases in the parameters associated with fundus.In addition,these indicators significantly correlate with the MMSE score and the MoCA score.OCTA may be an adjunct tool with strong potential to track changes in the diagnosis and monitoring the progression of the disease.展开更多
Voxel-based morphometry can be used to quantitatively compare structural differences and func-tional changes of gray matter in subjects. In the present study, we compared gray matter images of 32 patients with Parkin...Voxel-based morphometry can be used to quantitatively compare structural differences and func-tional changes of gray matter in subjects. In the present study, we compared gray matter images of 32 patients with Parkinson’s disease and 25 healthy controls using voxel-based morphometry based on 3.0 T high-field magnetic resonance T1-weighted imaging and clinical neurological scale scores. Results showed that the scores in Mini-Mental State Examination and Montreal Cognitive Assessment were lower in patients compared with controls. In particular, the scores of visuospatial/executive function items in Montreal Cognitive Assessment were significantly reduced, but mean scores of non-motor symptoms significantly increased, in patients with Parkinson’s dis-ease. In addition, gray matter volume was significantly diminished in Parkinson’s disease patients compared with normal controls, including bilateral temporal lobe, bilateral occipital lobe, bilateral parietal lobe, bilateral frontal lobe, bilateral insular lobe, bilateral parahippocampal gyrus, bilateral amygdale, right uncus, and right posterior lobe of the cerebel um. These findings indicate that voxel-based morphometry can accurately and quantitatively assess the loss of gray matter volume in patients with Parkinson＇s disease, and provide essential neuroimaging evidence for multisystem pathological mechanisms involved in Parkinson’s disease.展开更多
BACKGROUND In recent years,the prevalence of Alzheimer’s disease(AD)has increased,which places a great burden on society and families and creates considerable challenges for medical services.N6-methyladenine(m6A)deox...BACKGROUND In recent years,the prevalence of Alzheimer’s disease(AD)has increased,which places a great burden on society and families and creates considerable challenges for medical services.N6-methyladenine(m6A)deoxyribonucleic acid(DNA)adenine methylation is a novel biomarker and is abundant in the brain,but less common in AD.We support to analyze the relationship between DNA m6A and cognition in patients with AD and normal controls(NCs)in China.AIM To analyze the relationship between the novel m6A DNA and cognition in patients with AD and NCs in China.METHODS A total of 179 AD patients(mean age 71.60±9.89 years;males:91;females:88)and 147 NCs(mean age 69.59±11.22 years;males:77;females:70)who were age-and sex-matched were included in our study.All subjects underwent neuropsychological scale assessment and magnetic resonance imaging examination.Apolipoprotein E(APOE)genotypes were measured through agarose gel electrophoresis.Global m6A levels were evaluated by a MethylFlash m6A DNA Methylation ELISA Kit(colorimetric).Global m6A levels in total DNA from ten AD patients with 18F-AV-45(florbetapir)positron emission tomography(PET)positivity and ten NCs with PET negativity were analyzed by dot blotting to determine the results.RESULTS Our ELISA results showed that the global m6A DNA levels in peripheral blood were different between patients with AD and NCs(P=0.002;<0.05).And ten AD patients who were PET positive and ten NCs who were PET negative also showed the same results through dot blotting.There were significant differences between the two groups,which indicated that the leukocyte m6A DNA levels were different(P=0.005;<0.05).The m6A level was approximately 8.33%lower in AD patients than in NCs(mean 0.011±0.006 vs 0.012±0.005).A significant correlation was found between the Montreal Cognitive Assessment score and the peripheral blood m6A level in the tested population(r=0.143,P=0.01;<0.05).However,no relationship was found with APOEε4(P=0.633,>0.05).Further studies should be performed to validate these findings.CONCLUSION Our results show that reduced global m6A DNA methylation levels are significantly lower in AD patients than in NCs by approximately 8.33%in China.展开更多
BACKGROUND Efficiently detecting Parkinson's disease(PD)with dementia(PDD)as soon as possible is an important issue in geriatric medicine.AIM To develop a model for predicting PDD based on various neuropsychologic...BACKGROUND Efficiently detecting Parkinson's disease(PD)with dementia(PDD)as soon as possible is an important issue in geriatric medicine.AIM To develop a model for predicting PDD based on various neuropsychological tests using data from a nationwide survey conducted by the Korean Centers for Disease Control and Prevention and to present baseline data for the early detection of PDD.METHODS This study comprised 289 patients who were 60 years or older with PD[110 with PDD and 179 Parkinson's Disease-Mild Cognitive Impairment(PD-MCI)].Regression with optimal scaling(ROS)was used to identify independent relationships between the neuropsychological test results and PDD.RESULTS In the ROS analysis,Korean version of mini mental state ex-amination(MMSE)(KOREAN version of MMSE)(b=-0.52,SE=0.16)and Hoehn and Yahr staging(b=0.44,SE=0.19)were significantly effective models for distinguishing PDD from PD-MCI(P<0.05),even after adjusting for all of the Parkinson's motor symptom and neuropsychological test results.The optimal number of categories(scaling factors)for KOREAN version of MMSE and Hoehn and Yahr Scale was 10 and 7,respectively.CONCLUSION The results of this study suggest that among the various neuropsychological tests conducted,the optimal classification scores for KOREAN version of MMSE and Hoehn and Yahr Scale could be utilized as an effective screening test for the early discrimination of PDD from PD-MCI.展开更多
Cognitive decline in late adulthood might be partially mediated by subclinical generalized vascular disease. If so, atherogenic factors such as pro-inflammatory cytokines might be mid-life targets for prevention or tr...Cognitive decline in late adulthood might be partially mediated by subclinical generalized vascular disease. If so, atherogenic factors such as pro-inflammatory cytokines might be mid-life targets for prevention or treatment. Dallas Heart Study subjects (n = 997;mean age = 42.94 ± 10.2 yrs) underwent blood assays of pro-inflammatory biomarkers associated with atherosclerosis and 8 years later completed a cognitive outcome measure, the Montreal Cognitive Assessment (MoCA). Markers included C-reactive protein (CRP), Interleukin-18 (IL-18), Lipoprotein-associated phospholipase (LP-PLA<sub>2</sub>), and Monocyte Chemoattractant Protein (MCP-1), with Apolipoprotein E4 (ApoE4) as a potential modifier. We found weak evidence for LP-PLA<sub>2</sub> and CRP as predictors of cognitive scores. No relationship was found between elevated MCP-1, IL-18 and cognition. Presence of the ApoE4 allele did not impact the relationship between biomarkers and cognitive function. Levels of atherogenesis-related pro-inflammatory blood biomarkers did not predict cognitive function in middle-aged adults after an interval of 8 years.展开更多
文摘Background:Cognitive assessments,such as the Montreal Cognitive Assessment(MoCA),use components that assume intact sensory abilities,however,adults show concomitant decreases in visual acuity with increasing age.Scores on cognitive assessments are typically lower for individuals with visual impairments compared to individuals with normal/corrected to normal vision.But it is not clear if lowers scores on cognitive assessments are due to the assessments relying on visual stimuli,or if individuals with visual impairments are actually more likely to have cognitive impairments.Therefore we simulated visual impairments,i.e.,reduced visual acuity and contrast sensitivity,in young healthy adults to determine how this impacts their scores on a measure of cognitive ability,i.e.,the MoCA.Methods:Participants(n=19)completed one of the three version of the MoCA under three conditions(20/20,simulated 20/80,simulated 20/200).The MoCA was administered following the clinical protocols.Only participants that scored>26(i.e.,normal cognitive function)at 20/20 were included in the analysis.For comparison,we included MoCA data from a sample of older adults with normal vision(n=19,Mage=74,Acuity M=0.04 logMAR,SD=0.16)or visual impairment(n=19,Mage=79,Acuity M=0.35 logMAR,SD=0.3).Results:Acuity of participants at 20/20(M=0.06 LogMAR,SD=0.1),simulated 20/80(M=0.63,SD=0.18)and simulated 20/200(M=0.88,SD=0.19)showed that the participants experienced simulated acuity loss with the goggles.For the MoCA scores,we found a main effect of acuity(F=16.22,P<0.001,η2=0.375,BF10=5,618).Planned post hoc comparisons showed a significant difference between scores with a 20/20 acuity(M=27.26,SD=0.93)and 20/80(M=24.74,SD=1.66,t=5.62,ptukey<0.001,d=1.88),and between 20/20 and 20/200(M=25.63,SD=1.46,t=3.63,ptukey=0.002,Cohen’s d=1.33).However,no difference was observed between 20/80 and 20/200(t=−1.99,ptukey=0.125,d=0.572).The MoCA scores in older adults with normal vision(M=27.32,SD=2.41)and with visual impairment(M=26.68,SD=2.52),did not differ significantly(t36=−0.787,P=0.436,d=0.26,BF10=0.4).Conclusions:Our findings show that simulated reductions in visual acuity and contrast sensitivity lead to lower scores on measures of cognitive ability,specifically the MoCA.However,it appears that older adults with actual visual impairments may have developed compensatory strategies to adapt to this loss in visual acuity as there were no significant differences in scores of older adults with and without visual impairments.Therefore,we would recommend that when assessing an individual with visual impairments to conduct the cognitive test by re-scoring it without the visual components,e.g.,the MoCA Blind,to magnify the visual components,or to substitue the visual component when possible using auditory alternatives,e.g.,the oral trail making task.
文摘[Purpose] This study aimed to evaluation of the Tokyo cognitive assessment (Toca) for predicting cognitive impairment in rehabilitation users. [Method] The variables of age, BMI, educational background, Toca for 36 rehabilitation users and 22 healthy elder were assessed. We compared cognitive functions in rehabilitation users who need support and healthy elders. [Results] Of the Toca 1 to 11 trials, there was a significant difference other than 9, 10 rials. The Toca scores with 8 points higher were significantly higher in healthy elders than in rehabilitation users. The area under the receiver-operator curve (AUC) for predicting mild cognitive impairment (MCI) by the Toca was 0.874. Using a cut-off point of 19/20, the Toca demonstrated a sensitivity of 83.9% and a sensitivity of 85.0% in diagnosing MCI. [Conclusion] The Toca is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in rehabilitation users.
基金Supported by Jiangsu Provincial Elderly Health Research Project,No.LR2021020,No,LD2021016Major Project of Wuxi Municipal Health Commission,No.Z202002Scientific Research Project of Jiangsu Provincial Health Commission,No.BJ21008.
文摘BACKGROUND The role of comprehensive geriatric assessment(CGA)in screening for mild cognitive disorders was not known.AIM To evaluate the role of CGA in screening for mild cognitive disorders.METHODS A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis.Using Petersen as the diagnostic gold standard,healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group.The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed.Patients'Montreal Cognitive Assessment(MoCA)and CGA screening results were compared,and the sensitivity and specificity were calculated to assess the screening role of CGA.RESULTS CGA assessment yielded higher diagnostic accuracy than MoCA.The results of the multivariate regression analysis showed no correlation of gender,age,body mass index and literacy with cognitive function.Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals(P<0.05).In the CGA scale,patients with mild cognitive impairment showed significantly lower Mini-mental State Examination,Miniature Nutritional Assessment and Berg Balance Scale scores,and higher Activity of Daily Living,Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals(P<0.05),whereas the other assessment scales showed no significant differences(P>0.05).The CGA provides higher diagnostic sensitivity and specificity than the MoCA(P<0.05).CONCLUSION CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity,facilitating timely and effective intervention,and is thus recommended for clinical use.
文摘This study explored the construction of power relations in the cognitive assessment of older adults within the Chinese clinical context.Data is derived from audio and video recordings that nine older adults produced in the cognitive assessment of the Chinese version of the Montreal Cognitive Assessment-Basic(MoCA-B),which were then annotated and analyzed from a multimodal pragmatic perspective.The study reveals that examiners and older adults employed various speech acts to achieve distinct communicative goals,with power relations between them being reflected through these speech acts.Examiners tend to claim high power,utilizing discourse strategies such as request,interruption,evaluation,rhetorical questions,and directive speech acts.In contrast,older adults assert high power through directive speech acts,rhetorical questions,and interruptions.Both parties also exhibit low power by using confirming questions and explanations.Additionally,gestures,smiles,prosody features,and other non-verbal communicative resources are synergistically employed to exercise power.The interactive mechanism of constructing power relations reveals that age affects older adults’power relations construction even in a professional setting of the Chinese context.The negotiation between the advanced age of older adults and the expertise of examiners jointly shapes power relations in their interactions.
文摘Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).
文摘Background： Nonlinguistic cognitive impairment has become an important issue for aphasic patients, but currently there are few neuropsychological cognitive assessment tests for it. To get more information on cognitive impairment of aphasic patients, this study aimed to develop a new cognitive assessment test battery for aphasic patients, the Non-language-based Cognitive Assessment （NLCA）, and evaluate its utility in Chinese-speaking patients with aphasia. Methods： The NLCA consists of five nonverbal tests, which could assess five nonlinguistic cognitive domains such as visuospatial functions, attention test, memory, reasoning, and executive functions of aphasic patients. All tests are modified from the nonverbal items of the current existed tests with some changes to the characteristics of Chinese culture. The NLCA was tested in 157 participants （including 57 aphasic patients, 50 mild cognitive impairment （MCI） patients, and 50 normal controls）, and was compared with other well-established relative neuropsychological tests on the reliability, validity, and utility. Results： The NLCA was fully applicable in the MCI patients and the normal controls, almost working in the aphasic patients （57/62 patients, 91.9%）. The NLCA scores were 66.70± 6.30, 48.67± 15.04, and 77.58±2.56 for the MCI group, the aphasic group, and the control group, respectively , and a significant difference was found among three groups （F = 118.446, P 〈 0.001）. The Cronbach＇s alpha of the NLCA as an index of internal consistency was 0.805, and the test-retest and interrater reliability was adequate （r=0.977 and r= 0.970, respectively）. The correlations of the cognitive subtests and their validation instruments were between 0.540 and 0.670 （all P 〈 0.05）. Spearman＆#39;s correlation analysis indicated that the coefficient of internal consistency of each subtest itself was higher than other subtests.When choosing the Montreal Cognitive Assessment score of 〈26 as the diagnostic criteria of cognitive impairment, the area under the curve for all participants in the control and MCI groups was 0.942 （95% confidence interval： 0.895–0.989）, and an optimal cutoff point of 75.00 seemed to provide the best balance between sensitivity and specificity. Age （r = -0.406, P 〈 0.001） was the main influence factor for the NLCA. Conclusions： The NLCA could efficiently differentiate the cognitive impairment patients from the normal controls and is a reliable and valid cognitive assessment test battery to specially find nonlinguistic cognitive function for aphasic patients.
文摘Purpose： To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment （MoCA） and Mini-Mental State Examination （MMSE） in patients with chronic traumatic brain injury （TBI） or stroke and to evaluate the sensitivity of the two scales in patients with TBI. Methods： In this cohort study, a total of 230 patients were evaluated, including TBI group （n = 103） and stroke group （n - 127）. The cognitive functions of two groups were evaluated by designated specialists using MoCA （Beijing version） and MMSE （Chinese version）. Results： Compared with the patients with stroke, the patients with TBI received significantly lower score in orientation subtest and recall subtest in both tests. MoCA abnormal rates in the TBI group and stroke group were 94.17% and 86.61% respectively, while MMSE abnormal rates were 69.90% and 57.48%, respectively. In the TBI group, 87.10% patients with normal MMSE score had abnormal MoCA score and in the stroke group, about 70.37% patients with normal MMSE score had abnormal MoCA score. The diagnostic consistency of two scales in the TBI group and the stroke group were 72% and 69%, re.spectively. Conclusion： In our rehabilitation center, patients with TBI may have mare extensive and severe cognitive impairments than patients with stroke, prominently in orientation and recall domain. In screening post- TBI cognitive impairment, MoCA tends to be more sensitive than MIV[SE.
文摘Cognitive decline in Parkinson’s disease (PD) is defined as dementia which affects activities of daily living (ADL) function. Dementia is one of the recognized issues in the treatment of Parkinson’s disease patients (PDP) as it is becoming a major contributor to morbidity. The objective of our study was to evaluate the cognitive decline in Parkinson’s disease patients (PDP) and the influence of cognition on daily living function deterioration in cognitively impaired and cognitively unimpaired PDP. Cognitively impaired PDP (n = 24), and cognitively unimpaired PDP (n = 16) were administered MoCA and MMSE performance based tests for cognitive measurements and Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL) to determine everyday functioning. The significances of MoCA and MMSE among cognitively impaired PDP and cognitively unimpaired PDP in univariant analysis were P < 0.001 and P < 0.05. In partial correlation, MoCA was strongly related to ADL function as compare to MMSE (r = 0.623, P = 0.001). Cognitively impaired PDP showed significantly lower score on visuo-construction and attention. Among all variables of MoCA domains, attention is strongly associated with instrumental activity daily living (IADL) scores (logistic regression coefficient = 0.672, P = 0.01). These results suggest that dementia affects daily living performances especially the IADL tasks like attention and execution. Therefore, the assessment of complex daily activities particularly IADL is probably useful for the diagnosis of early stage cognitive impairment in PDP. Further MMSE test is less sensitive than MoCA for detecting significant cognitive decline in PDP and impaired attention is an important determinant of ADL functions in cognitively impaired PDP.
文摘Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) and preclinical AD determined by Aβ load using PET. The goal of this study was to compare a new computerized version of the LASSI-L (LASSI-Brief Computerized) to the standard paper-and-pencil version of the test. In this study, we examined 110 cognitively unimpaired (CU) older adults and 79 with amnestic MCI (aMCI) who were administered the paper-and-pencil form of the LASSI-L. Their performance was compared with 62 CU older adults and 52 aMCI participants examined using the LASSI-BC. After adjustment for covariates (degree of initial learning, sex, education, and language of evaluation) both the standard and computerized versions distinguished between aMCI and CU participants. The performance of CU and aMCI groups using either form was relatively commensurate. Importantly, an optimal combination of Cued B2 recall and Cued B1 intrusions on the LASSI-BC yielded an area under the ROC curve of .927, a sensitivity of 92.3% and specificity of 88.1%, relative to an area under the ROC curve of .815, a sensitivity of 72.5%, and a specificity of 79.1% obtained for the paper-and-pencil LASSI-L. Overall, the LASSI-BC was comparable, and in some ways, superior to the paper-and-pencil LASSI-L. Advantages of the LASSI-BC include a more standardized administration, suitability for remote assessment, and an automated scoring mechanism that can be verified by a built-in audio recording of responses.
基金Supported by Science and Technology Support Projects in Biomedicine Field of Shanghai Science and Technology Commission,No.19441907500Naval Medical University Military Medical Innovation,No.2017JS07Science and Technology Action Innovation Program by Science and Technology Commission of Shanghai,No.17411950104
文摘BACKGROUND Post-stroke cognitive impairment(PSCI)is not only a common consequence of stroke but also an important factor for adverse prognosis of patients.Biochemical indicators such as blood lipids and blood pressure are affected by many factors,and the ability of evaluating the progress of patients with PSCI is insufficient.Therefore,it is necessary to find sensitive markers for predicting the progress of patients and avoiding PSCI.Recent studies have shown thatβ-amyloid protein 1-42(Aβ1-42)and thyroid hormone levels are closely related to PSCI,which may be the influencing factors of PSCI,but there are few related studies.AIM To investigate the relationship between serum levels of Aβand thyroid hormones in acute stage and PSCI and its predicted value.METHODS A total of 195 patients with acute cerebral infarction confirmed from June 2016 to January 2018 were enrolled in this study.Baseline data and serological indicators were recorded to assess cognitive function of patients.All patients were followed up for 1 year.Their cognitive functions were evaluated within 1 wk,3 mo,6 mo and 1 yr after stroke.At the end of follow-up,the patients were divided into PSCI and non-PSCI according to Montreal cognitive assessment score,and the relationship between biochemical indexes and the progression of PSCI was explored.RESULTS Compared with patients with non-PSCI,the levels of Aβ1-42,triiodothyronine(T3)and free thyroxin were lower in the patients with PSCI.Repeated measures analysis of variance showed that the overall content of Aβ1-42 and T3 in PSCI was also lower than that of the non-PSCI patients.Further analysis revealed that Aβ1-42(r=0.348),T3(r=0.273)and free thyroxin(r=0.214)were positively correlated with disease progression(P<0.05),suggesting that these indicators have the potential to predict disease progression and outcome.Cox regression analysis showed that Aβ1-42 and T3 were important factors of PSCI.Then stratified analysis showed that the lower the Aβ1-42 and T3,the higher risk of PSCI in patients who were aged over 70,female and illiterate.CONCLUSION Aβ1-42 and T3 have the ability to predict the progression of PSCI,which is expected to be applied clinically to reduce the incidence of PSCI and improve the quality of life of patients.
基金sponsored by Jiangsu Provincial Administration of Traditional Chinese Medicine, No. LB09090
文摘Patients with mild cognitive impairment after a transient ischemic attack were included in this study. They were treated with Yizhi Xingnao prescription, ergoloid mesylates or aspirin for 60 days. Evaluation using the Montreal Cognitive Assessment Scale showed that cognitive function was significantly improved in all patients, especially after the combined treatment of Yizhi Xingnao and aspirin. The scores from the Montreal Cognitive Assessment Scale were improved overall and the effective treatment rate was as high as 79%, which was higher than patients treated with a combination of ergoloid mesylates and aspirin, or aspirin alone. Our experimental findings indicate that YizhiXingnao prescription can improve mild cognitive impairment after a transient ischemic attack, and that it is more effective than ergoloid mesylates.
文摘The current pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly referred to as COVID-19, brings myriad challenges to research conducted among those more susceptible to the virus. According to the United States (US) Centers for Disease Control (CDC), eight out of ten re-ported COVID-19 deaths are among people > 65 years of age and older. Nonetheless, researchers must continue the crucial work of investigating and understanding diseases that affect the elderly. The focus of this white paper is to assess the challenges associated with research within the elderly population with neurocognitive conditions. Specifically, this paper addresses the need for the standardized administration of performance measures (e.g., neurocognitive assessments) among a dementia population while ensuring the physical safety of participants. Consideration is given to the administration of performance measures and the availability and feasibility of administering these measures remotely to a population that may have difficulty using novel technologies. In implementing remote research assessments, it is suggested that researchers fol-low a GAMMA approach by: 1) establishing clear Guidance on remote visit expectations and processes;2) establishing Appropriate exclusionary criteria in the development of the study design;3) providing subjects Appropriate study Materials for visual processing;4) incorporating Multiple data sources in the overall study design (e.g., caregiver input);and 5) Acknowledging that there will be study limitations as researchers use emerging technology with this patient population, and using mitigation strategies for these limitations where possible.
文摘BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus(GDM).METHODS The study subjects were divided into three groups:GDM group(n=81),healthy pregnant(HP)group(n=85),and control group(n=51).The Montreal Cognitive Assessment(MoCA)was used to assess the cognitive status of each group.Venous blood samples were collected to measure blood lipids,glycated hemoglobin,and glucose levels.For each participant,a 3-mL blood sample was collected and centrifuged,and the serum was collected.Blood samples were stored at-80℃,and DPP4,interleukin-6(IL-6),and 8-iso-prostaglandin F2α(8-iso-PGF2α),and brain-derived neurotrophic factor(BDNF)were detected using ELISA.RESULTS The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention(P<0.05);however,the scores were not significantly different between the GDM and HP groups(P>0.05).In terms of language,the GDM group had significantly different scores from those in the other two groups(P<0.05).In terms of memory,a significant difference was found between the HP and control groups(P<0.05),as well as between the GDM and HP groups.The levels of DPP4,IL-6,and 8-iso-PGF2αin the GDM group were significantly higher than those in the HP and control groups(P<0.05);however,the differences between these levels in the HP and control groups were not significant(P>0.05).The level of BDNF in the GDM group was significantly lower than that in the HP and control groups(P<0.05),although the difference in this level between the HP and control groups was not significant(P>0.05).CONCLUSION Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss,which might be associated with elevated DPP4 levels.
文摘Purpose: To investigate whether long-term noise exposure affects the cognitive ability of grinders. Methods: Cumulative noise exposure (CNE) and LAeq.8h determination were used to characterize the level of individual noise exposure;the Montreal Cognitive Assessment (MoCA) test (Beijing version) was used to evaluate cognitive function. Results: We compared the basic situation of workers in different groups and individual noise exposure intensity of grinders was monitored. Multiple linear-regression analysis was made and score of MoCA in different group was finally drawn. Conclusion: CNE and total score of MoCA have the relationship of negative correlation (r = -0.303, p < 0.05) which means long-term occupational noise exposure can affect the cognitive ability of grinders.
基金Clinical Study of Endovascular Treatment of Severe Middle Cerebral Artery Stenosis or Occlusion and Vascular Cognitive Impairment.Project No.:2019zc184。
文摘It is very important to study the factors affecting the incidence,progress and prognosis of patients with vascular dementia.50 cases of severe middle cerebral artery stenosis or occlusion underwent endovascular treatment(25 cases of mild cognitive dysfunction,25 cases of moderate cognitive dysfunction)were divided into two groups,where a medical drug treatment group and a control group established with 25 cases in each group.The cognitive function of each group of patients was evaluated before operation,7 days after operation,30 days after operation,and 180 days after operation.CTP was used to compare the hemodynamic changes in patients before and after operation.The severe stenosis or occlusion of the middle cerebral artery in patients can be improved,and the intracranial blood supply of patients with poorly compensated medial cranial circulation and hypoperfusion can be restored to a certain extent.Meanwhile,improvement of cognitive function was definitive in some patients with cognitive dysfunction.To guide the formulation of treatment plans for patients with severe middle cerebral artery stenosis or occlusion.
文摘AIM:To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia(ATD)using optical coherence tomography angiography(OCTA),to record flash electroretinograms(ERG)using the RETeval system and to explore changes in retinal function.METHODS:Twenty-nine patients with ATD and 26 age-matched normal subjects were enrolled.All subjects underwent OCTA scans to analyse the superficial retinal vessel parameters in the macular area,including the vessel length density,the vessel perfusion density and the area of foveal avascular zone(FAZ),as well as the choroidal thickness.The differences between the patients with ATD and the normal control group were compared and explored the relevant factors affecting vessel parameters.We also recorded the flash ERGs using the RETeval system and intended to explore changes in retinal function by analysing the ERG image amplitude in patients with ATD.RESULTS:The vessel parameters[Pvessel length density=0.005 and Pvessel perfusion density=0.006]and average choroid thickness(P<0.001)in the macular area of the ATD group was less than the control group.The FAZ area was statistically significantly enlarged in the ATD group(P<0.001).These parameters were correlated with the Mini-Mental State Examination(MMSE)score and the Montreal Cognitive Assessment(MoCA).CONCLUSION:Patients with ATD exhibit decreases in the parameters associated with fundus.In addition,these indicators significantly correlate with the MMSE score and the MoCA score.OCTA may be an adjunct tool with strong potential to track changes in the diagnosis and monitoring the progression of the disease.
基金supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions,the Medical Clinical Science and Technology Developemnt Fund of Jiangsu University,No.JLY20120122Innovative Climb Program of Natural Science Foundation of Jiangsu Province,No.BK2008010the Natural Science Foundation of Nantong University,No.11Z001
文摘Voxel-based morphometry can be used to quantitatively compare structural differences and func-tional changes of gray matter in subjects. In the present study, we compared gray matter images of 32 patients with Parkinson’s disease and 25 healthy controls using voxel-based morphometry based on 3.0 T high-field magnetic resonance T1-weighted imaging and clinical neurological scale scores. Results showed that the scores in Mini-Mental State Examination and Montreal Cognitive Assessment were lower in patients compared with controls. In particular, the scores of visuospatial/executive function items in Montreal Cognitive Assessment were significantly reduced, but mean scores of non-motor symptoms significantly increased, in patients with Parkinson’s dis-ease. In addition, gray matter volume was significantly diminished in Parkinson’s disease patients compared with normal controls, including bilateral temporal lobe, bilateral occipital lobe, bilateral parietal lobe, bilateral frontal lobe, bilateral insular lobe, bilateral parahippocampal gyrus, bilateral amygdale, right uncus, and right posterior lobe of the cerebel um. These findings indicate that voxel-based morphometry can accurately and quantitatively assess the loss of gray matter volume in patients with Parkinson＇s disease, and provide essential neuroimaging evidence for multisystem pathological mechanisms involved in Parkinson’s disease.
基金Supported by the National Key R&D Program of China,No.2016YFC1306300and the National Natural Science Foundation of China,No.81974220.
文摘BACKGROUND In recent years,the prevalence of Alzheimer’s disease(AD)has increased,which places a great burden on society and families and creates considerable challenges for medical services.N6-methyladenine(m6A)deoxyribonucleic acid(DNA)adenine methylation is a novel biomarker and is abundant in the brain,but less common in AD.We support to analyze the relationship between DNA m6A and cognition in patients with AD and normal controls(NCs)in China.AIM To analyze the relationship between the novel m6A DNA and cognition in patients with AD and NCs in China.METHODS A total of 179 AD patients(mean age 71.60±9.89 years;males:91;females:88)and 147 NCs(mean age 69.59±11.22 years;males:77;females:70)who were age-and sex-matched were included in our study.All subjects underwent neuropsychological scale assessment and magnetic resonance imaging examination.Apolipoprotein E(APOE)genotypes were measured through agarose gel electrophoresis.Global m6A levels were evaluated by a MethylFlash m6A DNA Methylation ELISA Kit(colorimetric).Global m6A levels in total DNA from ten AD patients with 18F-AV-45(florbetapir)positron emission tomography(PET)positivity and ten NCs with PET negativity were analyzed by dot blotting to determine the results.RESULTS Our ELISA results showed that the global m6A DNA levels in peripheral blood were different between patients with AD and NCs(P=0.002;<0.05).And ten AD patients who were PET positive and ten NCs who were PET negative also showed the same results through dot blotting.There were significant differences between the two groups,which indicated that the leukocyte m6A DNA levels were different(P=0.005;<0.05).The m6A level was approximately 8.33%lower in AD patients than in NCs(mean 0.011±0.006 vs 0.012±0.005).A significant correlation was found between the Montreal Cognitive Assessment score and the peripheral blood m6A level in the tested population(r=0.143,P=0.01;<0.05).However,no relationship was found with APOEε4(P=0.633,>0.05).Further studies should be performed to validate these findings.CONCLUSION Our results show that reduced global m6A DNA methylation levels are significantly lower in AD patients than in NCs by approximately 8.33%in China.
基金Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education,No. NRF-2018R1D1A1B07041091 and No. NRF-2021S1A5A80625262022 Development of Open-Lab based on 4P in the Southeast Zone
文摘BACKGROUND Efficiently detecting Parkinson's disease(PD)with dementia(PDD)as soon as possible is an important issue in geriatric medicine.AIM To develop a model for predicting PDD based on various neuropsychological tests using data from a nationwide survey conducted by the Korean Centers for Disease Control and Prevention and to present baseline data for the early detection of PDD.METHODS This study comprised 289 patients who were 60 years or older with PD[110 with PDD and 179 Parkinson's Disease-Mild Cognitive Impairment(PD-MCI)].Regression with optimal scaling(ROS)was used to identify independent relationships between the neuropsychological test results and PDD.RESULTS In the ROS analysis,Korean version of mini mental state ex-amination(MMSE)(KOREAN version of MMSE)(b=-0.52,SE=0.16)and Hoehn and Yahr staging(b=0.44,SE=0.19)were significantly effective models for distinguishing PDD from PD-MCI(P<0.05),even after adjusting for all of the Parkinson's motor symptom and neuropsychological test results.The optimal number of categories(scaling factors)for KOREAN version of MMSE and Hoehn and Yahr Scale was 10 and 7,respectively.CONCLUSION The results of this study suggest that among the various neuropsychological tests conducted,the optimal classification scores for KOREAN version of MMSE and Hoehn and Yahr Scale could be utilized as an effective screening test for the early discrimination of PDD from PD-MCI.
文摘Cognitive decline in late adulthood might be partially mediated by subclinical generalized vascular disease. If so, atherogenic factors such as pro-inflammatory cytokines might be mid-life targets for prevention or treatment. Dallas Heart Study subjects (n = 997;mean age = 42.94 ± 10.2 yrs) underwent blood assays of pro-inflammatory biomarkers associated with atherosclerosis and 8 years later completed a cognitive outcome measure, the Montreal Cognitive Assessment (MoCA). Markers included C-reactive protein (CRP), Interleukin-18 (IL-18), Lipoprotein-associated phospholipase (LP-PLA<sub>2</sub>), and Monocyte Chemoattractant Protein (MCP-1), with Apolipoprotein E4 (ApoE4) as a potential modifier. We found weak evidence for LP-PLA<sub>2</sub> and CRP as predictors of cognitive scores. No relationship was found between elevated MCP-1, IL-18 and cognition. Presence of the ApoE4 allele did not impact the relationship between biomarkers and cognitive function. Levels of atherogenesis-related pro-inflammatory blood biomarkers did not predict cognitive function in middle-aged adults after an interval of 8 years.
