Previous studies have shown that the compound(E)-2-(3,4-dihydroxystyryl)-3-hydroxy-4H-pyran-4-one(D30),a pyromeconic acid derivative,possesses antioxidant and anti-inflammatory properties,inhibits amyloid-β aggregati...Previous studies have shown that the compound(E)-2-(3,4-dihydroxystyryl)-3-hydroxy-4H-pyran-4-one(D30),a pyromeconic acid derivative,possesses antioxidant and anti-inflammatory properties,inhibits amyloid-β aggregation,and alleviates scopolamine-induced cognitive impairment,similar to the phase Ⅲ clinical drug resveratrol.In this study,we established a mouse model of Alzheimer's disease via intracerebroventricular injection of fibrillar amyloid-β to investigate the effect of D30 on fibrillar amyloid-β-induced neuropathology.Our results showed that D30 alleviated fibrillar amyloid-β-induced cognitive impairment,promoted fibrillar amyloid-β clearance from the hippocampus and cortex,suppressed oxidative stress,and inhibited activation of microglia and astrocytes.D30 also reversed the fibrillar amyloid-β-induced loss of dendritic spines and synaptic protein expression.Notably,we demonstrated that exogenous fibrillar amyloid-βintroduced by intracerebroventricular injection greatly increased galectin-3 expression levels in the brain,and this increase was blocked by D30.Considering the role of D30 in clearing amyloid-β,inhibiting neuroinflammation,protecting synapses,and improving cognition,this study highlights the potential of galectin-3 as a promising treatment target for patients with Alzheimer's disease.展开更多
Poststro ke cognitive impairment is a major secondary effect of ischemic stroke in many patients;however,few options are available for the early diagnosis and treatment of this condition.The aims of this study were to...Poststro ke cognitive impairment is a major secondary effect of ischemic stroke in many patients;however,few options are available for the early diagnosis and treatment of this condition.The aims of this study were to(1)determine the specific relationship between hypoxic andα-synuclein during the occur of poststroke cognitive impairment and(2)assess whether the serum phosphorylatedα-synuclein level can be used as a biomarker for poststro ke cognitive impairment.We found that the phosphorylatedα-synuclein level was significantly increased and showed pathological aggregation around the cerebral infa rct area in a mouse model of ischemic stroke.In addition,neuronalα-synuclein phosphorylation and aggregation were observed in the brain tissue of mice subjected to chronic hypoxia,suggesting that hypoxia is the underlying cause ofα-synuclein-mediated pathology in the brains of mice with ischemic stroke.Serum phosphorylatedα-synuclein levels in patients with ischemic stroke were significantly lower than those in healt hy subjects,and were positively correlated with cognition levels in patients with ischemic stroke.Furthermore,a decrease in serum high-density lipoprotein levels in stroke patie nts was significantly correlated with a decrease in phosphorylatedα-synuclein levels.Although ischemic stroke mice did not show significant cognitive impairment or disrupted lipid metabolism 14 days after injury,some of them exhibited decreased cognitive function and reduced phosphorylatedα-synuclein levels.Taken together,our results suggest that serum phosphorylatedα-synuclein is a potential biomarker for poststroke cognitive impairment.展开更多
BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patie...BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.展开更多
Cognitive impairment is a particularly severe non-motor symptom of Parkinson's disease that significantly diminishes the quality of life of affected individuals.Identifying reliable biomarkers for cognitive impair...Cognitive impairment is a particularly severe non-motor symptom of Parkinson's disease that significantly diminishes the quality of life of affected individuals.Identifying reliable biomarkers for cognitive impairment in Parkinson's disease is essential for early diagnosis,prognostic assessments,and the development of targeted therapies.This review aims to summarize recent advancements in biofluid biomarkers for cognitive impairment in Parkinson's disease,focusing on the detection of specific proteins,metabolites,and other biomarkers in blood,cerebrospinal fluid,and saliva.These biomarkers can shed light on the multifaceted etiology of cognitive impairment in Parkinson's disease,which includes protein misfolding,neurodegeneration,inflammation,and oxidative stress.The integration of biofluid biomarkers with neuroimaging and clinical data can facilitate the development of predictive models to enhance early diagnosis and monitor the progression of cognitive impairment in patients with Parkinson's disease.This comprehensive approach can improve the existing understanding of the mechanisms driving cognitive decline and support the development of targeted therapeutic strategies aimed at modifying the course of cognitive impairment in Parkinson's disease.Despite the promise of these biomarkers in characterizing the mechanisms underlying cognitive decline in Parkinson's disease,further research is necessary to validate their clinical utility and establish a standardized framework for early detection and monitoring of cognitive impairment in Parkinson's disease.展开更多
Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult ...Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases.Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits.This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment.Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment,including cerebrovascular diseases,Alzheimer's disease,aging-related conditions,and issues related to anesthesia and surgery.The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized,and targeting AHN is considered a promising approach for treating cognitive impairment.However,the underlying mechanisms of this role are not yet fully understood,and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited,with a need for further development of treatment methods and detection techniques.By reviewing recent studies,we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories:immunity,energy metabolism,aging,and pathological states.In immunity-related mechanisms,abnormalities in meningeal,brain,and peripheral immunity can disrupt normal adult hippocampal neurogenesis.Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis.During aging,the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients.Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis.Among the current strategies used to enhance this form of neurogenesis,physical therapies such as exercise,transcutaneous electrical nerve stimulation,and enriched environments have proven effective.Dietary interventions,including energy intake restriction and nutrient optimization,have shown efficacy in both basic research and clinical trials.However,drug treatments,such as antidepressants and stem cell therapy,are primarily reported in basic research,with limited clinical application.The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention,and targeting the former may be an important strategy for treating the latter.However,the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear,and treatments are lacking.This highlights the need for greater focus on translating research findings into clinical practice.展开更多
Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a common form of sleep breathing disorder characterized by apnea and hypopnea resulting from recurrent upper airway obstruction during sleep.This leads to intermitten...Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a common form of sleep breathing disorder characterized by apnea and hypopnea resulting from recurrent upper airway obstruction during sleep.This leads to intermittent hypoxia in the brain and disruptions in sleep architecture,ultimately causing cognitive impairment.In OSAHS patients,cognitive dysfunction manifests mainly as diminished attention,memory,and executive function.These effects impact an individual’s daily and social abilities,significantly reducing their quality of life.This article primarily reviews four aspects of OSAHS patients’cognitive function,namely,characteristics,pathogenesis,assessment tools,influencing factors,and heterogeneity,to provide a theoretical basis for healthcare professionals to identify high-risk groups for cognitive impairment among OSAHS patients at an early stage and to construct a more objective and feasible intervention program to further prevent the occurrence and development of dementia.展开更多
Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia a...Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.展开更多
BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status o...BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.展开更多
BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and...BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.展开更多
BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor ...BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.展开更多
Objectives:The current study aimed to perform a meta-analysis to comprehensively investigate effect of physical activity on cognitive function in people with Mild Cognitive Impairment.The findings of this study can of...Objectives:The current study aimed to perform a meta-analysis to comprehensively investigate effect of physical activity on cognitive function in people with Mild Cognitive Impairment.The findings of this study can offer an important basis for identifying the significance of physical activity as an important factor in designing and implementing strategies to enhance cognitive function in mild cognitive impairment.Methods:21 articles were selected through academic databases(EBSCOhost,PubMed,ScienceDirect,Web of Science),and 20 Montreal Cognitive Assessment(MoCA)data and 15 Mini-Mental State Examination(MMSE)data were obtained.The study was conducted using the meta-analysis.To test the validity of each article included in this study,a funnel plot and Egger’s regression analysis were carried out to check for publication bias.Results:The 95%confidence interval(CI)for the effect size was interpreted as a small effect size if the effect size was between 0.2 and 0.5,a moderate effect size if the effect size was between 0.5 and 0.8,and large if the effect size was greater than 0.8.First,the meta-analysis of MoCA data showed a large effect size of 0.96;second,the meta-analysis of MMSE data indicated a large effect size of 0.93;and third,the meta-analysis of MoCA and MMSE data together indicated a moderate effect size of 0.68.Conclusion:The current study demonstrates the significant effect of physical activity on cognitive function and provides a basis for developing programs to improve cognitive function.People diagnosed with mild cognitive impairment generally experience minimal disruption in daily living activities.However,as the severity of the condition progresses,significant challenges emerge,impacting the individual’s ability to carry out daily tasks.Research has demonstrated that physical activity can enhance cognitive function in individuals with MCI.Consequently,it is recommended that these individuals be motivated to participate in physical activity to optimize their cognitive function and enhance their overall quality of life.展开更多
Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension a...Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.展开更多
BACKGROUND Acute ischemic stroke(AIS)is a significant global health issue with increasing incidence owing to aging populations and rising cardiovascular risk factors.In addition to physical impairments,AIS frequently ...BACKGROUND Acute ischemic stroke(AIS)is a significant global health issue with increasing incidence owing to aging populations and rising cardiovascular risk factors.In addition to physical impairments,AIS frequently leads to neuropsychiatric co-mplications,such as cognitive impairment,anxiety,and depressive symptoms,which adversely affect patients’quality of life and rehabilitation.Neutrophil ge-latinase-associated lipocalin(NGAL)has emerged as a potential biomarker for various conditions,including AIS.This study investigated the association bet-ween serum NGAL levels at admission and neuropsychiatric complications in patients with AIS.neuropsychiatric complications in patients with AIS.METHODS Between January 2022 and December 2023,150 patients with AIS were enrolled.Serum NGAL levels were measured at admission using an enzyme-linked immu-nosorbent assay.Cognitive function was assessed using the Mini-Mental State Examination,while anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale at discharge.The relationship between serum NGAL levels and cognitive impairment,anxiety,and depressive symptoms was analyzed using multivariate logistic regression,adjusted for potential con-founders of age,sex,body mass index,smoking status,hypertension,diabetes mellitus,dyslipidemia,previous stroke,and stroke severity.RESULTS The mean age of the participants was 65.4±10.2 years,and 58%were males.Prevalence rates of cognitive impairment,anxiety,and depressive symptoms at discharge were 34.7%,28.0%,and 32.0%,respectively.Serum NGAL levels were significantly higher in patients with cognitive impairment(median:5.6 ng/mL vs 3.2 ng/mL,P<0.001),anxiety(median:5.1 ng/mL vs 3.5 ng/mL,P=0.002),and depressive symptoms(median:5.4 ng/mL vs 3.3 ng/mL,P<0.001),compared to those without these conditions.Multivariate logistic regression analysis showed that higher serum NGAL levels at admission were independently associated with cognitive impairment[odds ratio(OR)=1.42,95%confidence interval(CI):1.18-1.71,P<0.001],anxiety(OR=1.28,95%CI:1.09-1.51,P=0.003),and depressive symptoms(OR=1.39,95%CI:1.16-1.67,P<0.001)after adjusting for potential confounders.CONCLUSION Elevated serum NGAL levels were independently associated with cognitive impairment,anxiety,and depressive symptoms in patients with AIS;and may function as potential biomarkers for patients at risk.展开更多
BACKGROUND Chronic kidney disease(CKD)patients have been found to be at risk of concurrent cognitive dysfunction in previous studies,which has now become an important public health issue of widespread concern.AIM To i...BACKGROUND Chronic kidney disease(CKD)patients have been found to be at risk of concurrent cognitive dysfunction in previous studies,which has now become an important public health issue of widespread concern.AIM To investigate the risk factors for concurrent cognitive dysfunction in patients with CKD.METHODS This is a prospective cohort study conducted among patients with CKD between October 2021 and March 2023.A questionnaire was formulated by literature review and expert consultation and included questions about age,sex,education level,per capita monthly household income,marital status,living condition,payment method,and hypertension.RESULTS Logistic regression analysis showed that patients aged 60-79 years[odds ratio(OR)=1.561,P=0.015]and≥80 years(OR=1.760,P=0.013),participants with middle to high school education(OR=0.820,P=0.027),divorced or widowed individuals(OR=1.37,P=0.032),self-funded patients(OR=2.368,P=0.008),and patients with hypertension(OR=2.011,P=0.041)had a higher risk of cognitive impairment.The risk of cognitive impairment was lower for those with a college degree(OR=0.435,P=0.034)and married individuals.CONCLUSION The risk factors affecting cognitive dysfunction are age,60-79 years and≥80 years;education,primary school education or less;marital status,divorced or widowed;payment method,selffunded;hypertension;and CKD.展开更多
Glyphosate-based herbicides are widely used around the world, making it likely that most humans have significant exposure. Because of habitual exposure, there are concerns about toxicity including neurotoxicity that c...Glyphosate-based herbicides are widely used around the world, making it likely that most humans have significant exposure. Because of habitual exposure, there are concerns about toxicity including neurotoxicity that could result in neurological, psychiatric, or cognitive impairment. We recently found that a single injection of glyphosate inhibits long-term potentiation, a cellular model of learning and memory, in rat hippocampal slices dissected 1 day after injection, indicating that glyphosate-based herbicides can alter cognitive function. Glyphosate-based herbicides could adversely affect cognitive function either indirectly and/or directly. Indirectly, glyphosate could affect gut microbiota, and if dysbiosis results in endotoxemia(leaky gut), infiltrated bacterial by-products such as lipopolysaccharides could activate pro-inflammatory cascades. Glyphosate can also directly trigger pro-inflammatory cascades. Indeed, we observed that acute glyphosate exposure inhibits long-term potentiation in rat hippocampal slices. Interestingly, direct inhibition of long-term potentiation by glyphosate appears to be similar to that of lipopolysaccharides. There are several possible measures to control dysbiosis and neuroinflammation caused by glyphosate. Dietary intake of polyphenols, such as quercetin, which overcome the inhibitory effect of glyphosate on long-term potentiation, could be one effective strategy. The aim of this narrative review is to discuss possible mechanisms underlying neurotoxicity following glyphosate exposure as a means to identify potential treatments.展开更多
Objective:Cancer survivors have experienced subjective cognitive impairment(SCI)when they received cancer diagnoses or treatments.Their psychosocial and emotional statuses were also impacted.With the advancement of we...Objective:Cancer survivors have experienced subjective cognitive impairment(SCI)when they received cancer diagnoses or treatments.Their psychosocial and emotional statuses were also impacted.With the advancement of web technologies,web-based cognitive interventions have been implemented in the management and the alleviation of the SCI,the psychosocial distress,and the emotional distress in cancer survivors.This review aimed to summarize the intervention contents of web-based cognitive interventions for SCI,and to explore the effects of the interventions on SCI,psychosocial status,and emotional health.Methods:Six databases(CINAHL Plus,Cochrane Library,Embase,APA PsycInfo,PubMed and CNKI)were searched from the establishment of databases up to December 2023.Literature references were also manually searched for related articles.Results:This review contained 21 studies that covered the contents of web-based cognitive interventions,such as computer-assisted cognitive training,online cognitive rehabilitation,cognitive behavior therapy with the Internet,telehealth physical exercise,and web-based mindfulness interventions.The effects of web-based cognitive interventions positively impacted SCI for cancer survivors.Also,these interventions showed varying degrees of effectiveness in alleviating psychosocial and emotional distresses.Conclusion:By summarizingfive types of cognitive intervention contents delivered via web technology,this review demonstrated that web-based cognitive interventions optimized SCI and overall psychosocial and emotional statuses for the cancer survivors.It is recommended that future research focus on the development of customized web-based cognitive interventions for individuals with SCI,along with their psychosocial and emotional statuses.展开更多
Neurosyphilis(NS)is an infectious disease caused by Treponema pallidum invading the central nervous system.It can manifest at any stage of syphilis,and is often misdiagnosed due to its atypical and progressive symptom...Neurosyphilis(NS)is an infectious disease caused by Treponema pallidum invading the central nervous system.It can manifest at any stage of syphilis,and is often misdiagnosed due to its atypical and progressive symptoms.The increasing incidence of NS underscores the necessity for early and accurate diagnosis.Here,we present a case where routine cerebrospinal fluid metagenomic next-generation sequencing(mNGS)was used to diagnose a patient with neurosyphilis.The patient exhibited cognitive impairment and was initially diagnosed with cerebral infarction due to syphilitic cerebral arteritis.Thus,the patient was treated with dual antiplatelet therapy(aspirin and clopidogrel)and statins to stabilize the plaques.Neurosyphilis was treated with penicillin sodium injections,resulting in significant improvement in the patient’s mental state.This case is a rare instance of neurosyphilis associated with cerebral infarction.These findings suggest that mNGS is a valuable tool in diagnosing neurosyphilis,potentially improving diagnostic accuracy and patient outcomes.展开更多
Neuroimaging has emerged over the last few decades as a crucial tool in diagnosing Alzheimer’s disease(AD).Mild cognitive impairment(MCI)is a condition that falls between the spectrum of normal cognitive function and...Neuroimaging has emerged over the last few decades as a crucial tool in diagnosing Alzheimer’s disease(AD).Mild cognitive impairment(MCI)is a condition that falls between the spectrum of normal cognitive function and AD.However,previous studies have mainly used handcrafted features to classify MCI,AD,and normal control(NC)individuals.This paper focuses on using gray matter(GM)scans obtained through magnetic resonance imaging(MRI)for the diagnosis of individuals with MCI,AD,and NC.To improve classification performance,we developed two transfer learning strategies with data augmentation(i.e.,shear range,rotation,zoom range,channel shift).The first approach is a deep Siamese network(DSN),and the second approach involves using a cross-domain strategy with customized VGG-16.We performed experiments on the Alzheimer’s Disease Neuroimaging Initiative(ADNI)dataset to evaluate the performance of our proposed models.Our experimental results demonstrate superior performance in classifying the three binary classification tasks:NC vs.AD,NC vs.MCI,and MCI vs.AD.Specifically,we achieved a classification accuracy of 97.68%,94.25%,and 92.18%for the three cases,respectively.Our study proposes two transfer learning strategies with data augmentation to accurately diagnose MCI,AD,and normal control individuals using GM scans.Our findings provide promising results for future research and clinical applications in the early detection and diagnosis of AD.展开更多
This study investigated the association of hypertension with cognitive impairment and determined whether better adherence to plant-based diet(PBD)patterns may modify the association.We analyzed 4485 elderly individual...This study investigated the association of hypertension with cognitive impairment and determined whether better adherence to plant-based diet(PBD)patterns may modify the association.We analyzed 4485 elderly individuals with normal cognition at baseline from the Chinese Longitudinal Healthy Longevity Survey(2011−2018).Cognitive function was assessed by the Mini-mental State Examination(MMSE),and cognitive impairment was defined as an MMSE score below 18 points.Diet patterns were assessed using the overall plant-based diet index(PDI),healthful plant-based diet index(hPDI),and unhealthful plant-based diet index(uPDI)derived from a simplified food frequency questionnaire(FFQ).Blood pressure was measured through physical examination.Cox proportional hazard regression and restricted cubic spline were performed.Participants with hypertension had an increased risk of cognitive impairment compared with normal group.The associations between hypertension and cognitive impairment were more pronounced among participants with lower PDI than those with higher PDI,among participants with lower hPDI than those with higher hPDI,and among participants with higher uPDI than those with lower uPDI.A healthful PBD pattern may attenuate hypertension-induced cognitive impairment,while an unhealthful PBD pattern may exacerbate hypertensioninduced cognitive impairment in elderly.Adherence to healthful PBD pattern could be used to prevent or mitigate adverse neurological effects in the hypertensive population.展开更多
SIL1,an endoplasmic reticulum(ER)-resident protein,is reported to play a protective role in Alzheimer’s disease(AD).However,the effect of SIL1 on amyloid precursor protein(APP)processing remains unclear.In this study...SIL1,an endoplasmic reticulum(ER)-resident protein,is reported to play a protective role in Alzheimer’s disease(AD).However,the effect of SIL1 on amyloid precursor protein(APP)processing remains unclear.In this study,the role of SIL1 in APP processing was explored both in vitro and in vivo.In the in vitro experiment,SIL1 was either overexpressed or knocked down in cells stably expressing the human Swedish mutant APP695.In the in vivo experiment,AAV-SIL1-EGFP or AAV-EGFP was microinjected into APP23/PS45 mice and their wild-type littermates.Western blotting(WB),immunohistochemistry,RNA sequencing(RNA-seq),and behavioral experiments were performed to evaluate the relevant parameters.Results indicated that SIL1 expression decreased in APP23/PS45 mice.Overexpression of SIL1 significantly decreased the protein levels of APP,presenilin-1(PS1),and C-terminal fragments(CTFs)of APP in vivo and in vitro.Conversely,knockdown of SIL1 increased the protein levels of APP,β-site APP cleavage enzyme 1(BACE1),PS1,and CTFs,as well as APP mRNA expression in 2EB2 cells.Furthermore,SIL1 overexpression reduced the number of senile plaques in APP23/PS45 mice.Importantly,Y-maze and Morris Water maze tests demonstrated that SIL1 overexpression improved cognitive impairment in APP23/PS45 mice.These findings indicate that SIL1 improves cognitive impairment in APP23/PS45 mice by inhibiting APP amyloidogenic processing and suggest that SIL1 is a potential therapeutic target for AD by modulating APP processing.展开更多
基金supported by the Research Foundation for Talented Scholars of Fujian Medical University,No.XRCZX2018014(to DZ)Startup Fund for Scientific Research,Fujian Medical University,No.2019QH1017(to CW)the Natural Science Foundation of Fujian Province,China,Nos.2021J01693(to DZ),2021J02032(to ZCY)。
文摘Previous studies have shown that the compound(E)-2-(3,4-dihydroxystyryl)-3-hydroxy-4H-pyran-4-one(D30),a pyromeconic acid derivative,possesses antioxidant and anti-inflammatory properties,inhibits amyloid-β aggregation,and alleviates scopolamine-induced cognitive impairment,similar to the phase Ⅲ clinical drug resveratrol.In this study,we established a mouse model of Alzheimer's disease via intracerebroventricular injection of fibrillar amyloid-β to investigate the effect of D30 on fibrillar amyloid-β-induced neuropathology.Our results showed that D30 alleviated fibrillar amyloid-β-induced cognitive impairment,promoted fibrillar amyloid-β clearance from the hippocampus and cortex,suppressed oxidative stress,and inhibited activation of microglia and astrocytes.D30 also reversed the fibrillar amyloid-β-induced loss of dendritic spines and synaptic protein expression.Notably,we demonstrated that exogenous fibrillar amyloid-βintroduced by intracerebroventricular injection greatly increased galectin-3 expression levels in the brain,and this increase was blocked by D30.Considering the role of D30 in clearing amyloid-β,inhibiting neuroinflammation,protecting synapses,and improving cognition,this study highlights the potential of galectin-3 as a promising treatment target for patients with Alzheimer's disease.
基金supported by the Scientific Research Project of China Rehabilitation Research Center,No.2021zx-23the National Natural Science Foundation of China,No.32100925the Beijing Nova Program,No.Z211100002121038。
文摘Poststro ke cognitive impairment is a major secondary effect of ischemic stroke in many patients;however,few options are available for the early diagnosis and treatment of this condition.The aims of this study were to(1)determine the specific relationship between hypoxic andα-synuclein during the occur of poststroke cognitive impairment and(2)assess whether the serum phosphorylatedα-synuclein level can be used as a biomarker for poststro ke cognitive impairment.We found that the phosphorylatedα-synuclein level was significantly increased and showed pathological aggregation around the cerebral infa rct area in a mouse model of ischemic stroke.In addition,neuronalα-synuclein phosphorylation and aggregation were observed in the brain tissue of mice subjected to chronic hypoxia,suggesting that hypoxia is the underlying cause ofα-synuclein-mediated pathology in the brains of mice with ischemic stroke.Serum phosphorylatedα-synuclein levels in patients with ischemic stroke were significantly lower than those in healt hy subjects,and were positively correlated with cognition levels in patients with ischemic stroke.Furthermore,a decrease in serum high-density lipoprotein levels in stroke patie nts was significantly correlated with a decrease in phosphorylatedα-synuclein levels.Although ischemic stroke mice did not show significant cognitive impairment or disrupted lipid metabolism 14 days after injury,some of them exhibited decreased cognitive function and reduced phosphorylatedα-synuclein levels.Taken together,our results suggest that serum phosphorylatedα-synuclein is a potential biomarker for poststroke cognitive impairment.
文摘BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.
基金supported by Applied Basic Research Foundation of Yunnan Province,Nos.202301AS070045,202101AY070001-115(to XY and BL)National Natural Science Foundation of China,No.81960242(to XY)。
文摘Cognitive impairment is a particularly severe non-motor symptom of Parkinson's disease that significantly diminishes the quality of life of affected individuals.Identifying reliable biomarkers for cognitive impairment in Parkinson's disease is essential for early diagnosis,prognostic assessments,and the development of targeted therapies.This review aims to summarize recent advancements in biofluid biomarkers for cognitive impairment in Parkinson's disease,focusing on the detection of specific proteins,metabolites,and other biomarkers in blood,cerebrospinal fluid,and saliva.These biomarkers can shed light on the multifaceted etiology of cognitive impairment in Parkinson's disease,which includes protein misfolding,neurodegeneration,inflammation,and oxidative stress.The integration of biofluid biomarkers with neuroimaging and clinical data can facilitate the development of predictive models to enhance early diagnosis and monitor the progression of cognitive impairment in patients with Parkinson's disease.This comprehensive approach can improve the existing understanding of the mechanisms driving cognitive decline and support the development of targeted therapeutic strategies aimed at modifying the course of cognitive impairment in Parkinson's disease.Despite the promise of these biomarkers in characterizing the mechanisms underlying cognitive decline in Parkinson's disease,further research is necessary to validate their clinical utility and establish a standardized framework for early detection and monitoring of cognitive impairment in Parkinson's disease.
基金supported by Technological Innovation 2030-Major Projects of“Brain Science and Brain-like Research,”No.2022ZD0206200(to XG)the National Natural Science Foundation of China,No.82371245(to SJ),82102246(to XD),81701092(to XG)+2 种基金the Natural Science Foundation of Shandong Province,No.ZR2020MH129(to SJ)Shanghai Municipal Key Clinical Specialty,No.shslczdzk03601Shanghai Engineering Research Center of Peri-operative Organ Support and Function Preservation,No.20DZ2254200。
文摘Adult hippocampal neurogenesis is linked to memory formation in the adult brain,with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons.Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases.Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits.This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment.Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment,including cerebrovascular diseases,Alzheimer's disease,aging-related conditions,and issues related to anesthesia and surgery.The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized,and targeting AHN is considered a promising approach for treating cognitive impairment.However,the underlying mechanisms of this role are not yet fully understood,and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited,with a need for further development of treatment methods and detection techniques.By reviewing recent studies,we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories:immunity,energy metabolism,aging,and pathological states.In immunity-related mechanisms,abnormalities in meningeal,brain,and peripheral immunity can disrupt normal adult hippocampal neurogenesis.Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis.During aging,the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients.Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis.Among the current strategies used to enhance this form of neurogenesis,physical therapies such as exercise,transcutaneous electrical nerve stimulation,and enriched environments have proven effective.Dietary interventions,including energy intake restriction and nutrient optimization,have shown efficacy in both basic research and clinical trials.However,drug treatments,such as antidepressants and stem cell therapy,are primarily reported in basic research,with limited clinical application.The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention,and targeting the former may be an important strategy for treating the latter.However,the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear,and treatments are lacking.This highlights the need for greater focus on translating research findings into clinical practice.
基金supported by the 2023 Jinzhou Medical University Education and Teaching Research and Reform Project(YB2023004).
文摘Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a common form of sleep breathing disorder characterized by apnea and hypopnea resulting from recurrent upper airway obstruction during sleep.This leads to intermittent hypoxia in the brain and disruptions in sleep architecture,ultimately causing cognitive impairment.In OSAHS patients,cognitive dysfunction manifests mainly as diminished attention,memory,and executive function.These effects impact an individual’s daily and social abilities,significantly reducing their quality of life.This article primarily reviews four aspects of OSAHS patients’cognitive function,namely,characteristics,pathogenesis,assessment tools,influencing factors,and heterogeneity,to provide a theoretical basis for healthcare professionals to identify high-risk groups for cognitive impairment among OSAHS patients at an early stage and to construct a more objective and feasible intervention program to further prevent the occurrence and development of dementia.
基金supported by the Major Programs of Public Health of the Chinese Ministry of Finance(grant number 131091106000150003)。
文摘Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.
文摘BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.
基金Supported by the Wuxi Science and Technology Plan Project Plan,No.BJ21008.
文摘BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2023ZL460Zhejiang Province Traditional Chinese Medicine Modernization Special Project,No.2021ZX011。
文摘BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.
文摘Objectives:The current study aimed to perform a meta-analysis to comprehensively investigate effect of physical activity on cognitive function in people with Mild Cognitive Impairment.The findings of this study can offer an important basis for identifying the significance of physical activity as an important factor in designing and implementing strategies to enhance cognitive function in mild cognitive impairment.Methods:21 articles were selected through academic databases(EBSCOhost,PubMed,ScienceDirect,Web of Science),and 20 Montreal Cognitive Assessment(MoCA)data and 15 Mini-Mental State Examination(MMSE)data were obtained.The study was conducted using the meta-analysis.To test the validity of each article included in this study,a funnel plot and Egger’s regression analysis were carried out to check for publication bias.Results:The 95%confidence interval(CI)for the effect size was interpreted as a small effect size if the effect size was between 0.2 and 0.5,a moderate effect size if the effect size was between 0.5 and 0.8,and large if the effect size was greater than 0.8.First,the meta-analysis of MoCA data showed a large effect size of 0.96;second,the meta-analysis of MMSE data indicated a large effect size of 0.93;and third,the meta-analysis of MoCA and MMSE data together indicated a moderate effect size of 0.68.Conclusion:The current study demonstrates the significant effect of physical activity on cognitive function and provides a basis for developing programs to improve cognitive function.People diagnosed with mild cognitive impairment generally experience minimal disruption in daily living activities.However,as the severity of the condition progresses,significant challenges emerge,impacting the individual’s ability to carry out daily tasks.Research has demonstrated that physical activity can enhance cognitive function in individuals with MCI.Consequently,it is recommended that these individuals be motivated to participate in physical activity to optimize their cognitive function and enhance their overall quality of life.
基金supported by the National Natural Science Foundation of China,Nos.82274611 (to LZ),82104419 (to DM)Capital Science and Technology Leading Talent Training Project,No.Z1 91100006119017 (to LZ)+3 种基金Beijing Hospitals Authority Ascent Plan,No.DFL20190803 (to LZ)Cultivation Fund of Hospital Management Center in Beijing,No.PZ2022006 (to DM)R&D Program of Beijing Municipal Education Commission,No.KM202210025017 (to DM)Beijing Gold-Bridge Project,No.ZZ20145 (to DM)。
文摘Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
基金Supported by Gansu Provincial Natural Science Foundation,No.20JR10RA671and The Fund of the First Hospital of Lanzhou University,No.ldyyyn2021-103.
文摘BACKGROUND Acute ischemic stroke(AIS)is a significant global health issue with increasing incidence owing to aging populations and rising cardiovascular risk factors.In addition to physical impairments,AIS frequently leads to neuropsychiatric co-mplications,such as cognitive impairment,anxiety,and depressive symptoms,which adversely affect patients’quality of life and rehabilitation.Neutrophil ge-latinase-associated lipocalin(NGAL)has emerged as a potential biomarker for various conditions,including AIS.This study investigated the association bet-ween serum NGAL levels at admission and neuropsychiatric complications in patients with AIS.neuropsychiatric complications in patients with AIS.METHODS Between January 2022 and December 2023,150 patients with AIS were enrolled.Serum NGAL levels were measured at admission using an enzyme-linked immu-nosorbent assay.Cognitive function was assessed using the Mini-Mental State Examination,while anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale at discharge.The relationship between serum NGAL levels and cognitive impairment,anxiety,and depressive symptoms was analyzed using multivariate logistic regression,adjusted for potential con-founders of age,sex,body mass index,smoking status,hypertension,diabetes mellitus,dyslipidemia,previous stroke,and stroke severity.RESULTS The mean age of the participants was 65.4±10.2 years,and 58%were males.Prevalence rates of cognitive impairment,anxiety,and depressive symptoms at discharge were 34.7%,28.0%,and 32.0%,respectively.Serum NGAL levels were significantly higher in patients with cognitive impairment(median:5.6 ng/mL vs 3.2 ng/mL,P<0.001),anxiety(median:5.1 ng/mL vs 3.5 ng/mL,P=0.002),and depressive symptoms(median:5.4 ng/mL vs 3.3 ng/mL,P<0.001),compared to those without these conditions.Multivariate logistic regression analysis showed that higher serum NGAL levels at admission were independently associated with cognitive impairment[odds ratio(OR)=1.42,95%confidence interval(CI):1.18-1.71,P<0.001],anxiety(OR=1.28,95%CI:1.09-1.51,P=0.003),and depressive symptoms(OR=1.39,95%CI:1.16-1.67,P<0.001)after adjusting for potential confounders.CONCLUSION Elevated serum NGAL levels were independently associated with cognitive impairment,anxiety,and depressive symptoms in patients with AIS;and may function as potential biomarkers for patients at risk.
文摘BACKGROUND Chronic kidney disease(CKD)patients have been found to be at risk of concurrent cognitive dysfunction in previous studies,which has now become an important public health issue of widespread concern.AIM To investigate the risk factors for concurrent cognitive dysfunction in patients with CKD.METHODS This is a prospective cohort study conducted among patients with CKD between October 2021 and March 2023.A questionnaire was formulated by literature review and expert consultation and included questions about age,sex,education level,per capita monthly household income,marital status,living condition,payment method,and hypertension.RESULTS Logistic regression analysis showed that patients aged 60-79 years[odds ratio(OR)=1.561,P=0.015]and≥80 years(OR=1.760,P=0.013),participants with middle to high school education(OR=0.820,P=0.027),divorced or widowed individuals(OR=1.37,P=0.032),self-funded patients(OR=2.368,P=0.008),and patients with hypertension(OR=2.011,P=0.041)had a higher risk of cognitive impairment.The risk of cognitive impairment was lower for those with a college degree(OR=0.435,P=0.034)and married individuals.CONCLUSION The risk factors affecting cognitive dysfunction are age,60-79 years and≥80 years;education,primary school education or less;marital status,divorced or widowed;payment method,selffunded;hypertension;and CKD.
基金supported by MH101874 (to CFZ)MH122379 (to CFZ)the Taylor Family Institute for Innovative Psychiatric Research and the Bantly Foundation (to CFZ)。
文摘Glyphosate-based herbicides are widely used around the world, making it likely that most humans have significant exposure. Because of habitual exposure, there are concerns about toxicity including neurotoxicity that could result in neurological, psychiatric, or cognitive impairment. We recently found that a single injection of glyphosate inhibits long-term potentiation, a cellular model of learning and memory, in rat hippocampal slices dissected 1 day after injection, indicating that glyphosate-based herbicides can alter cognitive function. Glyphosate-based herbicides could adversely affect cognitive function either indirectly and/or directly. Indirectly, glyphosate could affect gut microbiota, and if dysbiosis results in endotoxemia(leaky gut), infiltrated bacterial by-products such as lipopolysaccharides could activate pro-inflammatory cascades. Glyphosate can also directly trigger pro-inflammatory cascades. Indeed, we observed that acute glyphosate exposure inhibits long-term potentiation in rat hippocampal slices. Interestingly, direct inhibition of long-term potentiation by glyphosate appears to be similar to that of lipopolysaccharides. There are several possible measures to control dysbiosis and neuroinflammation caused by glyphosate. Dietary intake of polyphenols, such as quercetin, which overcome the inhibitory effect of glyphosate on long-term potentiation, could be one effective strategy. The aim of this narrative review is to discuss possible mechanisms underlying neurotoxicity following glyphosate exposure as a means to identify potential treatments.
基金The National Natural Science Foundation of China supports this review(No.82172844)The funder had no role in study design,data collection and analysis,manuscript preparation,or decision to publish.
文摘Objective:Cancer survivors have experienced subjective cognitive impairment(SCI)when they received cancer diagnoses or treatments.Their psychosocial and emotional statuses were also impacted.With the advancement of web technologies,web-based cognitive interventions have been implemented in the management and the alleviation of the SCI,the psychosocial distress,and the emotional distress in cancer survivors.This review aimed to summarize the intervention contents of web-based cognitive interventions for SCI,and to explore the effects of the interventions on SCI,psychosocial status,and emotional health.Methods:Six databases(CINAHL Plus,Cochrane Library,Embase,APA PsycInfo,PubMed and CNKI)were searched from the establishment of databases up to December 2023.Literature references were also manually searched for related articles.Results:This review contained 21 studies that covered the contents of web-based cognitive interventions,such as computer-assisted cognitive training,online cognitive rehabilitation,cognitive behavior therapy with the Internet,telehealth physical exercise,and web-based mindfulness interventions.The effects of web-based cognitive interventions positively impacted SCI for cancer survivors.Also,these interventions showed varying degrees of effectiveness in alleviating psychosocial and emotional distresses.Conclusion:By summarizingfive types of cognitive intervention contents delivered via web technology,this review demonstrated that web-based cognitive interventions optimized SCI and overall psychosocial and emotional statuses for the cancer survivors.It is recommended that future research focus on the development of customized web-based cognitive interventions for individuals with SCI,along with their psychosocial and emotional statuses.
文摘Neurosyphilis(NS)is an infectious disease caused by Treponema pallidum invading the central nervous system.It can manifest at any stage of syphilis,and is often misdiagnosed due to its atypical and progressive symptoms.The increasing incidence of NS underscores the necessity for early and accurate diagnosis.Here,we present a case where routine cerebrospinal fluid metagenomic next-generation sequencing(mNGS)was used to diagnose a patient with neurosyphilis.The patient exhibited cognitive impairment and was initially diagnosed with cerebral infarction due to syphilitic cerebral arteritis.Thus,the patient was treated with dual antiplatelet therapy(aspirin and clopidogrel)and statins to stabilize the plaques.Neurosyphilis was treated with penicillin sodium injections,resulting in significant improvement in the patient’s mental state.This case is a rare instance of neurosyphilis associated with cerebral infarction.These findings suggest that mNGS is a valuable tool in diagnosing neurosyphilis,potentially improving diagnostic accuracy and patient outcomes.
基金Research work funded by Zhejiang Normal University Research Fund YS304023947 and YS304023948.
文摘Neuroimaging has emerged over the last few decades as a crucial tool in diagnosing Alzheimer’s disease(AD).Mild cognitive impairment(MCI)is a condition that falls between the spectrum of normal cognitive function and AD.However,previous studies have mainly used handcrafted features to classify MCI,AD,and normal control(NC)individuals.This paper focuses on using gray matter(GM)scans obtained through magnetic resonance imaging(MRI)for the diagnosis of individuals with MCI,AD,and NC.To improve classification performance,we developed two transfer learning strategies with data augmentation(i.e.,shear range,rotation,zoom range,channel shift).The first approach is a deep Siamese network(DSN),and the second approach involves using a cross-domain strategy with customized VGG-16.We performed experiments on the Alzheimer’s Disease Neuroimaging Initiative(ADNI)dataset to evaluate the performance of our proposed models.Our experimental results demonstrate superior performance in classifying the three binary classification tasks:NC vs.AD,NC vs.MCI,and MCI vs.AD.Specifically,we achieved a classification accuracy of 97.68%,94.25%,and 92.18%for the three cases,respectively.Our study proposes two transfer learning strategies with data augmentation to accurately diagnose MCI,AD,and normal control individuals using GM scans.Our findings provide promising results for future research and clinical applications in the early detection and diagnosis of AD.
基金supported by the National Key R&D Program of China(2018YFC2000400)the National Natural Sciences Foundation of China(72061137004)+1 种基金the National Institute on Aging of National Institutes of Health(P01AG031719)Duke/DukeNUS(grant RECA(Pilot)/2019/0051 to Y.Z.).
文摘This study investigated the association of hypertension with cognitive impairment and determined whether better adherence to plant-based diet(PBD)patterns may modify the association.We analyzed 4485 elderly individuals with normal cognition at baseline from the Chinese Longitudinal Healthy Longevity Survey(2011−2018).Cognitive function was assessed by the Mini-mental State Examination(MMSE),and cognitive impairment was defined as an MMSE score below 18 points.Diet patterns were assessed using the overall plant-based diet index(PDI),healthful plant-based diet index(hPDI),and unhealthful plant-based diet index(uPDI)derived from a simplified food frequency questionnaire(FFQ).Blood pressure was measured through physical examination.Cox proportional hazard regression and restricted cubic spline were performed.Participants with hypertension had an increased risk of cognitive impairment compared with normal group.The associations between hypertension and cognitive impairment were more pronounced among participants with lower PDI than those with higher PDI,among participants with lower hPDI than those with higher hPDI,and among participants with higher uPDI than those with lower uPDI.A healthful PBD pattern may attenuate hypertension-induced cognitive impairment,while an unhealthful PBD pattern may exacerbate hypertensioninduced cognitive impairment in elderly.Adherence to healthful PBD pattern could be used to prevent or mitigate adverse neurological effects in the hypertensive population.
基金National Natural Science Foundation of China(82230043,82293642)。
文摘SIL1,an endoplasmic reticulum(ER)-resident protein,is reported to play a protective role in Alzheimer’s disease(AD).However,the effect of SIL1 on amyloid precursor protein(APP)processing remains unclear.In this study,the role of SIL1 in APP processing was explored both in vitro and in vivo.In the in vitro experiment,SIL1 was either overexpressed or knocked down in cells stably expressing the human Swedish mutant APP695.In the in vivo experiment,AAV-SIL1-EGFP or AAV-EGFP was microinjected into APP23/PS45 mice and their wild-type littermates.Western blotting(WB),immunohistochemistry,RNA sequencing(RNA-seq),and behavioral experiments were performed to evaluate the relevant parameters.Results indicated that SIL1 expression decreased in APP23/PS45 mice.Overexpression of SIL1 significantly decreased the protein levels of APP,presenilin-1(PS1),and C-terminal fragments(CTFs)of APP in vivo and in vitro.Conversely,knockdown of SIL1 increased the protein levels of APP,β-site APP cleavage enzyme 1(BACE1),PS1,and CTFs,as well as APP mRNA expression in 2EB2 cells.Furthermore,SIL1 overexpression reduced the number of senile plaques in APP23/PS45 mice.Importantly,Y-maze and Morris Water maze tests demonstrated that SIL1 overexpression improved cognitive impairment in APP23/PS45 mice.These findings indicate that SIL1 improves cognitive impairment in APP23/PS45 mice by inhibiting APP amyloidogenic processing and suggest that SIL1 is a potential therapeutic target for AD by modulating APP processing.
