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
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
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
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
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
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
Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer’s disease(MCI-AD). Methods: Totally 88 MCI-AD patients with synd...Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer’s disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P<0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P>0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P<0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P<0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.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.
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.
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.
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 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.
基金Supported by Fujian Provincial Research Project of Traditional Chinese Medicine(No.wzkf201309)
文摘Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer’s disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P<0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P>0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P<0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P<0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.
