Dementia and Geriatric Cognitive Disorders最新文献

When the phenomenal rise of artificial intelligence (AI) with super-human capabilities is juxtaposed against the relentless decline of a person with dementia, it lends the impression that AI is more human than the person with progressive dementia. However, to accord a higher standing to AI intuits a limited appreciation of what it means to be human. This article explicates how confronting the present day realities of AI and dementia can remind us of the foundations of being human and inspire better care for those living with dementia.

Introduction: Cognitive impairment represents a prevalent issue among patients undergoing hemodialysis (HD). Nevertheless, the majority of existing studies have predominantly focused on its influencing factors from a single-dimensional perspective. This study aimed to comprehensively investigate the multifaceted factors contributing to cognitive impairment in patients undergoing HD by applying the health ecological model.

Method: Data of 172 patients undergoing HD from the HD unit from China were collected from June 2022 to October 2022. A total of 24 variables were collected across the five dimensions of the health ecological model. The Montreal Cognitive Assessment (MoCA) scale was used to assess cognitive function. LASSO regression was utilized to select relevant variables, and binary logistic regression was employed to determine the independent risk factors associated with cognitive impairment.

Results: Gender, age, protein intake, and cholesterol were independently associated with cognitive impairment in patients undergoing HD. The predictive model incorporating these factors achieved a moderate goodness-of-fit (Nagelkerke R2 = 0.543), reflecting their combined contribution to cognitive risk.

Conclusion: Cognitive impairment is highly prevalent among Chinese patients undergoing HD, influenced by factors such as aging, female sex, insufficient protein intake, and low cholesterol levels. These findings underscore the multifactorial nature of cognitive decline in patients undergoing HD within the framework of a health ecological model, highlighting the need for comprehensive interventions that address biological, behavioral, psychological, disease-related, and social domains.

Introduction: We aimed to report the prevalence of mild cognitive impairment (MCI) among healthcare-seeking Indian older adults and study the relationship between serum leptin and adiponectin with MCI.

Methods: This cross-sectional study, conducted in a tertiary care center's Memory Clinic in India, utilized Clinical Dementia Rating (CDR) for patient categorization. Patients with a CDR of 0.5 were diagnosed with MCI, excluding those with a CDR >1. Biochemical markers, including leptin and adiponectin, were measured using ELISA.

Results: During the study period of 2 years, 163 patients were included. Among them, 84 (52%) had MCI, and 58 (69%) had amnestic MCI. Patients with MCI were older (69.4 vs. 67.4, p = 0.048) and more prevalent in males (29 [72.50%] vs. 11 [44.72%], p = 0.002). Poor education and lower socio-economic status were associated with MCI. Among comorbidities and geriatric syndromes, multi-morbidity (OR: 7.35; 95% CI: 3.44-15.69), diabetes (OR: 2.65; 95% CI: 1.25-5.63), cerebrovascular accident (OR: 27.68; 95% CI: 6.18-124.06), chronic obstructive pulmonary disease (OR: 4.77; 95% CI: 2.11-10.76), coronary artery disease (OR: 6.64; 95% CI: 2.30-19.12), and urinary incontinence (OR: 5.63; 95% CI: 2.25-14.11) were associated with MCI. Adiponectin was significantly lower in patients with MCI (1.36 vs. 2.50, p = 0.003), whereas serum leptin was higher (2.56 vs. 2.46, p = 0.827) but not significant after adjusting for age, sex, diabetes, and coronary artery disease.

Conclusion: In healthcare-seeking older patients MCI is prevalent and low serum adiponectin may serve as a valuable marker. Addressing multi-morbidity early at the primary care level could be a promising strategy for preventing dementia.

Introduction: Conventional non-pharmacological interventions for dementia and mild cognitive impairment (MCI) often face challenges related to motivation and adherence. Esports may offer a more intrinsically motivating alternative, but the evidence base remains limited. We aimed to map the existing evidence on esports interventions in individuals with clinically diagnosed dementia or MCI.

Methods: This rapid scoping review followed PRISMA-ScR, Joanna Briggs Institute, and Cochrane rapid review methods guidance. Searches were conducted in six bibliographic databases (MEDLINE, CENTRAL, Embase, PsycINFO, Web of Science, CINAHL). We also searched one gray-literature database (BASE) and two trial registries (WHO ICTRP, ClinicalTrials.gov) for records up to 8 April 2025. Eligible studies included primary research evaluating esports interventions.

Results: Six studies, including three randomized controlled trials (intervention group: n = 84), were included. All interventions utilized exergames delivered via commercial gaming consoles (Nintendo Wii or Switch, Microsoft Xbox Kinect). Samples were small (n = 3-23). Participants frequently reported favorable psychosocial effects - such as enjoyment and program satisfaction; however, objective end points were seldom assessed. Across the limited quantitative data, no trial demonstrated significant gains in global cognition, and findings for physical performance were inconsistent. No serious adverse events were reported; however, safety monitoring was inconsistently described.

Conclusion: Current evidence is insufficient to support esports as a therapeutic approach for dementia or MCI. Although participants consistently enjoyed the sessions, these subjective benefits alone do not establish clinical efficacy. Larger, well-controlled trials with validated cognitive and physical outcomes are needed before esports can be considered for routine care.

Introduction: Progranulin (PGRN), a secreted glycoprotein, plays a crucial role in several biological processes. However, its association with cognitive impairment in patients with coronary artery disease (CAD) remains unclear. This study aimed to evaluate the relationship between serum PGRN levels and cognitive impairment in patients with CAD.

Methods: A total of 177 patients with CAD and 150 non-CAD controls were included, and serum PGRN concentrations and other CAD-related risk factors were measured. Cognitive function was assessed, and logistic regression analysis was performed to identify the predictors of mild cognitive impairment (MCI).

Results: In a comparison between patients with CAD (n = 177) and non-CAD (n = 150), CAD with MCI (n = 64), and CAD without MCI (n = 113), patients with CAD and CAD with MCI had significantly lower levels of PGRN (94.99 ± 11.23 ng/mL and 89.41 ± 9.53 ng/mL) than those of non-CAD and CAD without MCI (127.64 ± 14.06 ng/mL and 98.15 ± 10.92 ng/mL, respectively). Multivariate analysis revealed that lower PGRN levels (odds ratio [OR] = 0.937, 95% confidence interval [CI] = 0.897-0.979; p = 0.004) and elevated levels of high-sensitivity C-reactive protein (OR = 9.525, 95% CI = 1.485-61.098; p = 0.017), tumor necrosis factor-alpha (OR = 1.257, 95% CI = 1.107-1.427; p < 0.001), and transforming growth factor-beta 1 (OR = 1.153, 95% CI = 1.036-1.284; p = 0.009) were independent risk factors for MCI. Conversely, higher brain-derived neurotrophic factor levels were protective (OR 0.809, 95% CI = 0.734-0.892; p < 0.001). Receiver operating characteristic analysis identified a PGRN cutoff of 93.52 ng/mL as predictive of MCI risk in patients with CAD.

Conclusion: These findings suggest that reduced serum PGRN levels are associated with cognitive impairment in CAD, highlighting their potential role as biomarkers.

Introduction: This article aimed to analyze the association between subjective memory complaints (SMCs) and cognitive performance in elderly indigenous individuals of the Xukuru do Ororubá ethnicity in Brazil.

Methods: This was a population-based, cross-sectional, analytical survey with data collected from 2015 to 2018. Participants answered questionnaires on sociodemographic and economic aspects, chronic diseases, habits, memory complaint, cognitive assessment, symptoms of depression, and activities of daily living.

Results: Overall, 559 older individuals participated in the study (71.3 ± 8.8 years; 55.8% female); the majority were illiterate (67.6%), whereas 24.3% received up to 4 years of education. Regarding clinical aspects, 8.7% reported polypharmacy, 25.6% exercised, 66.9% had hypertension, 15.2% had diabetes, 65% had vision problems, 27.7% had hearing problems, 53.1% had cognitive impairment, and 37.2% had symptoms of depression. The frequency of memory complaints was 54.4% (95% CI: 50.2-58.5). Cognitive deficits were not significantly associated with SMCs (OR, 1.09; 95% CI: 0.76-1.55; p = 0.645). In the multivariate analysis, significance was found for females (OR: 1.49 [95% CI: 1.04-2.14]; p = 0.03), self-reported falling with loss of consciousness (OR: 1.79 [95% CI: 1.08-2.98]; p = 0.025) and falling within the last year (OR: 1.79 [95% CI: 1.19-2.71]; p = 0.005), and visual (OR: 2.33 [95% CI: 1.64-3.33]; p = 0.001) and hearing impairment (OR: 2.44 [95% CI: 1.64-3.62]; p = 0.001), with a two-fold increase in both. Regular exercise was protective with a 36% reduction in chance. The chances of SMCs were higher in individuals with up to 4 years of schooling, but did not increase with more than 5 years of schooling; however, this variable had a small sample size.

Conclusion: No significant association was found between memory complaints and cognitive decline, but SMCs were associated with several factors, such as female sex, falling, and sensory loss, while exercising was found to be protective.

Introduction: Group music reminiscence therapy is often a preferred option for people with dementia owing to its efficacy in evoking autobiographical memories. Live music performances may further enhance interpersonal connections and social relationships, leading to a more meaningful participation. While an updated review on the efficacy of group music reminiscence therapy was published recently, only studies with pre-recorded music were included.

Methods: This systematic review focused on the effects of group live music reminiscence therapy on the cognition, behavioural and psychological symptoms, and quality of life of people with dementia. We conducted the initial search on September 1, 2024, following the PRISMA guidelines using PubMed and Scopus. We then reran searches prior to the final analysis on March 20, 2025. We assessed the risk of bias using Cochrane Collaboration's tool and assigned level of recommendations according to the American Academy of Neurology guideline.

Results: Of 1,846 articles, six studies involving 330 people with dementia and 10 caregivers were included. We assigned Level B recommendations for depression and anxiety in people with dementia. Findings on cognition, other behavioural and psychological symptoms, and quality of life were either limited or preliminary. Four studies reported qualitative findings and were synthesised into the following themes: (1) psychological well-being and improvements in mood; (2) engagement and participation.

Conclusion: Studies on group live music reminiscence therapy showed beneficial effects on depression and anxiety symptoms in people with dementia, while evidence for managing agitation and wandering, and improving the quality of life of people with dementia remains scarce and generally inconclusive. This warrants further investigation for meaningful clinical translation.

Background: Parkinson's disease (PD), a progressive neurodegenerative disorder, affects millions globally, with cognitive impairment as a significant non-motor complication. These cognitive changes, ranging from mild cognitive impairment to severe dementia, drastically reduce quality of life and worsen prognosis. Early and accurate detection is critical for effective management and therapeutic interventions.

Summary: Recent advancements in artificial intelligence (AI) offer novel solutions for diagnosing, predicting, and managing cognitive deficits in PD by integrating diverse data modalities, including neuroimaging, electrophysiology, kinetic markers, and laboratory biomarkers. Prominent AI techniques, such as support vector machines, random forests, and convolutional neural networks, have demonstrated high accuracy in analyzing multimodal data for cognitive profile prediction. Additionally, AI supports the development of personalized treatment strategies, both pharmacological and non-pharmacological, and enhances accessibility through telemedicine initiatives. Despite these advancements, challenges persist in standardizing methodologies, improving model interpretability, and integrating AI tools into clinical practice. Overcoming these hurdles will require robust validation studies and multidisciplinary collaboration.

Key messages: This review examines the transformative role of AI in analyzing multimodal datasets to classify cognitive impairments, predict disease progression, and identify therapeutic targets, paving the way for personalized, patient-centered care in PD management.

Introduction: Cognitive impairment among older adults is a significant public health concern worldwide. This study aimed to investigate the prevalence of cognitive impairment, its correlates, and the mediating role of depressive symptoms between frailty and cognitive impairment among older adults in northeast region of China.

Methods: This was a cross-sectional study which used the intercept interview method to recruit participants. Social demographic characteristic, health-related behaviours, physical health, and functional status of the participants were collected. Univariate and multivariate analyses were conducted to correlates of cognitive impairment. Additionally, mediating effect analysis was performed using the Bootstrap tool.

Results: Among the 2,859 older adults included in the study, 32.4% of participants screened positive for cognitive impairment. Higher educational attainment had negative association with cognitive impairment in older adults (p < 0.05). Living in rural areas, fair/poor self-rated health, pre-frailty, frailty, having depressive symptoms, impaired activities of daily living, poor sleep quality, and inactive physical activity had positive association with cognitive impairment in older adults (p < 0.05). Furthermore, depressive symptoms exhibited a partial mediating role between frailty and cognitive impairment, with a mediating effect of 58.0%.

Conclusions: Preventive measures should be implemented to address the associated factors with cognitive impairment. Promoting higher education levels, advocating for a positive and healthy lifestyle, and ensuring their physical and mental well-being among older adults are essential. Early diagnosis and proactive prevention of frailty and depressive symptoms in older adults may effectively decelerate cognitive decline.

Introduction: Obstructive sleep apnea (OSA) is associated with subjective cognitive decline (SCD) and increased risk of cognitive decline and dementia. These relations are understudied in ethnoracially diverse groups. We examined associations among self-reported OSA risk, SCD, and cognitive performance in community-dwelling older Latinos. High OSA risk was hypothesized to be associated with greater SCD and worse cognitive performance.

Methods: 112 participants (40 female) from the Boston Latino Aging Study (BLAST) were included (Mage = 67.0 years [SD = 8.0]; Meducation = 11.0 years [SD = 5.1]). Participants completed the Preclinical Alzheimer's Cognitive Composite-5 (PACC5; z-scores), the Berlin Questionnaire (high vs. low OSA risk), and the Cognitive Function Instrument (SCD). The Mini-Mental State Examination (MMSE) indexed global cognition. Hierarchical regressions assessed associations among OSA risk, SCD, and cognitive performance while controlling for demographics. t tests examined demographic and cognitive differences between those at high/low OSA risk.

Results: On average, participants had an MMSE score of 25.9 (SD = 3.7, range 11-30; 37 participants with MMSE <26) and mild SCD (CFI; M = 4.2 [3.6]). OSA risk did not predict SCD (β = 0.09, p = 0.33) or PACC5 performance (β = 0.01, p = 0.92). No differences in SCD or PACC5 performance were observed between those at low versus high OSA risk (p's ≥ 0.21).

Conclusion: Preliminary findings suggest that self-reported OSA risk may not signal cognitive decline risk for older Latinos. Questionnaires screening for OSA may need to be used in tandem with other assessments to identify those experiencing early cognitive decline. More work with larger sample sizes is needed; BLAST data collection is ongoing.