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The Acceptability and Usefulness of Cognitive Stimulation Therapy for Older Adults with Dementia: A Narrative Review. 认知刺激疗法对老年痴呆患者的可接受性和有效性:一项叙述性回顾。
Q1 Neuroscience Pub Date : 2016-01-01 Epub Date: 2016-07-11 DOI: 10.1155/2016/5131570
Hui Moon Toh, Shazli Ezzat Ghazali, Ponnusamy Subramaniam

Cognitive stimulation therapy (CST) is an evidence-based therapy for individuals with mild-to-moderate dementia. Past reviews have only synthesized outcomes obtained through quantitative study which does not fully represent the understanding on the acceptability and usefulness of CST. Therefore, the present review aims to integrate outcomes obtained from both quantitative and qualitative studies to provide a deeper understanding on the acceptability and usefulness of CST for older adults with dementia. Findings of literature were retrieved from searches of computerized databases in relation to CST for people with dementia. Literatures were selected according to selection criteria outlined. Results obtained in previous studies pertaining to the effects of CST were discussed in relation to variables such as cognitive function, quality of life, and family caregivers' wellbeing. The review also explores the use of CST in different cultural context, the perception on its effectiveness, and individualized CST (iCST). There is considerable evidence obtained through quantitative and qualitative studies on the usefulness and acceptability of CST for older adults with dementia. Recommendations for future research are provided to strengthen the evidence of CST's effectiveness.

认知刺激疗法(CST)是一种针对轻度至中度痴呆患者的循证疗法。以往的综述只是综合了定量研究的结果,不能完全代表对CST可接受性和有用性的认识。因此,本综述旨在整合定量和定性研究的结果,以更深入地了解CST对老年痴呆患者的可接受性和有用性。文献的发现是从计算机数据库中检索到的,与痴呆症患者的CST有关。根据概述的选择标准进行文献选择。先前关于CST影响的研究结果与认知功能、生活质量和家庭照顾者的健康等变量有关。本文还探讨了不同文化背景下CST的使用、对其有效性的认知以及个性化CST (iCST)。通过定量和定性研究获得了相当多的证据,证明CST对老年痴呆患者的有用性和可接受性。为加强CST有效性的证据,对未来的研究提出了建议。
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引用次数: 29
Family Dynamics and Personal Strengths among Dementia Caregivers in Argentina. 阿根廷痴呆症照护者的家庭动态和个人优势。
Q1 Neuroscience Pub Date : 2016-01-01 Epub Date: 2016-06-20 DOI: 10.1155/2016/2386728
Aaliah G Elnasseh, Michael A Trujillo, Silvina Victoria Peralta, Miriam E Stolfi, Eliana Morelli, Paul B Perrin, Juan Carlos Arango-Lasprilla

This study examined whether healthier family dynamics were associated with higher personal strengths of resilience, sense of coherence, and optimism among dementia caregivers in Argentina. Caregivers are usually required to assist individuals with dementia, and family members have typically fulfilled that role. Personal strengths such as resilience, sense of coherence, and optimism have been shown to protect caregivers from some of the negative experiences of providing care, though the family-related variables associated with these personal strengths are largely unknown. Hierarchical multiple regressions investigated the extent to which family dynamics variables are associated with each of the caregiver personal strengths after controlling for demographic and caregiver characteristics. A sample of 105 caregivers from Argentina completed a set of questionnaires during a neurologist visit. Family dynamics explained 32% of the variance in resilience and 39% of the variance in sense of coherence. Greater family empathy and decreased family problems were uniquely associated with higher resilience. Greater communication and decreased family problems were uniquely associated with higher sense of coherence. Optimism was not found to be significantly associated with family dynamics. These results suggest that caregiver intervention research focused on the family may help improve caregiver personal strengths in Argentina and other Latin American countries.

本研究探讨了更健康的家庭动态是否与阿根廷痴呆症照护者更高的个人抗逆力、连贯感和乐观主义有关。照护者通常需要帮助痴呆症患者,而家庭成员通常会扮演这一角色。复原力、连贯感和乐观主义等个人特长已被证明可以保护照顾者免受提供照顾过程中的一些负面经历的影响,但与这些个人特长相关的家庭变量在很大程度上还不为人所知。在控制了人口统计学和照顾者特征之后,分层多重回归研究了家庭动态变量与照顾者个人力量的关联程度。来自阿根廷的 105 名护理人员在神经科医生就诊期间填写了一组调查问卷。家庭动力解释了 32% 的复原力差异和 39% 的一致性差异。更多的家庭共鸣和更少的家庭问题与更高的复原力有着独特的联系。更多的沟通和更少的家庭问题与更高的和谐感有着独特的联系。乐观情绪与家庭动态关系不大。这些结果表明,以家庭为重点的照顾者干预研究可能有助于提高阿根廷和其他拉丁美洲国家照顾者的个人能力。
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引用次数: 0
Driving Competence in Mild Dementia with Lewy Bodies: In Search of Cognitive Predictors Using Driving Simulation 轻度路易体痴呆患者的驾驶能力:利用驾驶模拟寻找认知预测因子
Q1 Neuroscience Pub Date : 2015-12-02 DOI: 10.1155/2015/806024
Stephanie Yamin, A. Stinchcombe, S. Gagnon
Driving is a multifactorial behaviour drawing on multiple cognitive, sensory, and physical systems. Dementia is a progressive and degenerative neurological condition that impacts the cognitive processes necessary for safe driving. While a number of studies have examined driving among individuals with Alzheimer's disease, less is known about the impact of Dementia with Lewy Bodies (DLB) on driving safety. The present study compared simulated driving performance of 15 older drivers with mild DLB with that of 21 neurologically healthy control drivers. DLB drivers showed poorer performance on all indicators of simulated driving including an increased number of collisions in the simulator and poorer composite indicators of overall driving performance. A measure of global cognitive function (i.e., the Mini Mental State Exam) was found to be related to the overall driving performance. In addition, measures of attention (i.e., Useful Field of View, UFOV) and space processing (Visual Object and Space Perception, VOSP, Test) correlated significantly with a rater's assessment of driving performance.
驾驶是一种多因素行为,涉及多个认知、感觉和身体系统。痴呆症是一种进行性和退行性神经系统疾病,影响安全驾驶所必需的认知过程。虽然有许多研究调查了阿尔茨海默病患者的驾驶情况,但对路易体痴呆(DLB)对驾驶安全的影响知之甚少。相比,本研究模拟驾驶操作15老司机有轻微下文与21个神经健康控制驱动程序。DLB驾驶员在模拟驾驶的所有指标上表现较差,包括模拟器中的碰撞次数增加,整体驾驶性能的综合指标较差。整体认知功能的测量(即迷你精神状态测试)被发现与整体驾驶表现有关。此外,注意力测量(即有用视野,UFOV)和空间处理(视觉对象和空间感知,VOSP,测试)与评分者对驾驶表现的评估显着相关。
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引用次数: 24
PET Imaging of Epigenetic Influences on Alzheimer's Disease 表观遗传学对阿尔茨海默病影响的PET成像
Q1 Neuroscience Pub Date : 2015-10-22 DOI: 10.1155/2015/575078
P. J. Couto, R. Millis
The precise role of environment-gene interactions (epigenetics) in the development and progression of Alzheimer's disease (AD) is unclear. This review focuses on the premise that radiotracer-specific PET imaging allows clinicians to visualize epigenetically influenced events and that such imaging may provide new, valuable insights for preventing, diagnosing, and treating AD. Current understanding of the role of epigenetics in AD and the principles underlying the use of PET radiotracers for in vivo diagnosis are reviewed. The relative efficacies of various PET radiotracers for visualizing the epigenetic influences on AD and their use for diagnosis are discussed. For example, [18F]FAHA demonstrates sites of differential HDAC activity, [18F]FDG indirectly illuminates sites of neuronal hypomethylation, and the carbon-11 isotope-containing Pittsburgh compound B ([11C]PiB) images amyloid-beta plaque deposits. A definitive AD diagnosis is currently achievable only by postmortem histological observation of amyloid-beta plaques and tau neurofibrillary tangles. Therefore, reliable in vivo neuroimaging techniques could provide opportunities for early diagnosis and treatment of AD.
环境-基因相互作用(表观遗传学)在阿尔茨海默病(AD)发生和进展中的确切作用尚不清楚。本综述的前提是,放射性示踪剂特异性PET成像允许临床医生可视化表观遗传影响事件,并且这种成像可能为预防、诊断和治疗AD提供新的、有价值的见解。目前对表观遗传学在AD中的作用的理解以及PET放射性示踪剂用于体内诊断的基本原理进行了综述。讨论了各种PET示踪剂在观察表观遗传对AD的影响及其在诊断中的应用的相对效果。例如,[18F]FAHA显示了HDAC活性差异位点,[18F]FDG间接阐明了神经元低甲基化位点,含有碳-11同位素的匹兹堡化合物B ([11C]PiB)显示了淀粉样β斑块沉积。明确的AD诊断目前只能通过死后淀粉样斑块和tau神经原纤维缠结的组织学观察来实现。因此,可靠的体内神经成像技术可以为AD的早期诊断和治疗提供机会。
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引用次数: 15
Evaluating Adult's Competency: Application of the Competency Assessment Process. 成人胜任力之评估:胜任力评估程序之应用。
Q1 Neuroscience Pub Date : 2015-01-01 Epub Date: 2015-07-15 DOI: 10.1155/2015/753873
Dominique Giroux, Sylvie Tétreault, Marie-Pier Landry

Competency assessment of adults with cognitive impairment or mental illness is a complex process that can have significant consequences for their rights. Some models put forth in the scientific literature have been proposed to guide health and social service professionals with this assessment process, but none of these appear to be complete. A new model, the Competency Assessment Process (CAP), was presented and validated in other studies. This paper adds to this corpus by presenting both the CAP model and the results of a survey given to health and social service professionals on its practical application in their clinical practice. The survey was administered to 35 participants trained in assessing competency following the CAP model. The results show that 40% of participants use the CAP to guide their assessment and the majority of those who do not yet use it plan to do so in the future. A large majority of participants consider this to be a relevant model and believe that all interdisciplinary teams should use it. These results support the relevance of the CAP model. Further research is planned to continue the study of the application of CAP in healthcare facilities.

对患有认知障碍或精神疾病的成年人进行能力评估是一个复杂的过程,可能对他们的权利产生重大影响。科学文献中提出了一些模型,以指导卫生和社会服务专业人员进行这一评估过程,但这些模型似乎都不完整。提出了一种新的胜任力评估过程(CAP)模型,并在其他研究中得到了验证。本文通过介绍CAP模型和对卫生和社会服务专业人员在其临床实践中的实际应用进行的调查结果,增加了这个语料库。该调查对35名接受过能力评估培训的参与者进行了管理。结果显示,40%的参与者使用CAP来指导他们的评估,而大多数尚未使用CAP的参与者计划在未来这样做。大多数参与者认为这是一个相关的模型,并认为所有跨学科团队都应该使用它。这些结果支持了CAP模型的相关性。计划进行进一步的研究,继续研究CAP在医疗设施中的应用。
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引用次数: 3
Auditory and Visual Cues for Topic Maintenance with Persons Who Exhibit Dementia of Alzheimer's Type. 阿尔茨海默氏型痴呆患者话题维持的听觉和视觉提示。
Q1 Neuroscience Pub Date : 2015-01-01 Epub Date: 2015-06-10 DOI: 10.1155/2015/126064
Amy F Teten, Paul A Dagenais, Mary J Friehe

This study compared the effectiveness of auditory and visual redirections in facilitating topic coherence for persons with Dementia of Alzheimer's Type (DAT). Five persons with moderate stage DAT engaged in conversation with the first author. Three topics related to activities of daily living, recreational activities, food, and grooming, were broached. Each topic was presented three times to each participant: once as a baseline condition, once with auditory redirection to topic, and once with visual redirection to topic. Transcripts of the interactions were scored for overall coherence. Condition was a significant factor in that the DAT participants exhibited better topic maintenance under visual and auditory conditions as opposed to baseline. In general, the performance of the participants was not affected by the topic, except for significantly higher overall coherence ratings for the visually redirected interactions dealing with the topic of food.

本研究比较了听觉和视觉重定向在促进阿尔茨海默氏型痴呆(DAT)患者主题连贯性方面的有效性。5名中度阶段DAT患者与第一作者进行了对话。他们提出了与日常生活活动、娱乐活动、食物和打扮有关的三个主题。每个主题向每个参与者展示三次:一次作为基线条件,一次以听觉重定向到主题,一次以视觉重定向到主题。对相互作用的转录本进行整体一致性评分。条件是DAT参与者在视觉和听觉条件下表现出比基线更好的主题维持的重要因素。总的来说,参与者的表现不受主题的影响,除了在处理食物主题的视觉重定向互动中显着提高了整体一致性评级。
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引用次数: 0
Inhibitory effects of sodium arsenite and acacia honey on acetylcholinesterase in rats. 亚砷酸钠和金合欢蜂蜜对大鼠乙酰胆碱酯酶的抑制作用。
Q1 Neuroscience Pub Date : 2015-01-01 Epub Date: 2015-03-02 DOI: 10.1155/2015/903603
Aliyu Muhammad, Oyeronke A Odunola, Michael A Gbadegesin, Abdullahi B Sallau, Uche S Ndidi, Mohammed A Ibrahim

This study was conducted to investigate the effect of sodium arsenite and Acacia honey on acetylcholinesterase (AChE) activity and electrolytes in the brain and serum of Wistar rats. Male Wistar albino rats in four groups of five rats each were treated with distilled water, sodium arsenite (5 mg/kg body weight), Acacia honey (20% v/v), and sodium arsenite and Acacia honey, daily for one week. The sodium arsenite and Acacia honey significantly (P < 0.05) decreased AChE activity in the brain with the combined treatment being more potent. Furthermore, sodium arsenite and Acacia honey significantly (P < 0.05) decreased AChE activity in the serum. Strong correlation was observed between the sodium and calcium ion levels with acetylcholinesterase activity in the brain and serum. The gas chromatography mass spectrometry analysis of Acacia honey revealed the presence of a number of bioactive compounds such as phenolics, sugar derivatives, and fatty acids. These findings suggest that sodium arsenite and/or Acacia honey modulates acetylcholinesterase activities which may be explored in the management of Alzheimer's diseases but this might be counteracted by the hepatotoxicity induced by arsenics.

本实验研究了亚砷酸钠和金合欢蜂蜜对Wistar大鼠脑和血清乙酰胆碱酯酶(AChE)活性和电解质的影响。雄性Wistar白化大鼠4组,每组5只,每日分别用蒸馏水、亚砷酸钠(5 mg/kg体重)、金合花蜂蜜(20% v/v)、亚砷酸钠和金合花蜂蜜治疗1周。亚砷酸钠和金合欢蜂蜜显著(P < 0.05)降低了大鼠脑内乙酰胆碱酯酶活性,且联合用药效果更显著。亚砷酸钠和金合欢蜂蜜显著(P < 0.05)降低血清乙酰胆碱酯酶活性。脑和血清中钠、钙离子水平与乙酰胆碱酯酶活性有较强的相关性。对金合欢蜂蜜的气相色谱质谱分析揭示了许多生物活性化合物的存在,如酚类物质、糖衍生物和脂肪酸。这些发现表明,亚砷酸钠和/或刺槐蜂蜜可以调节乙酰胆碱酯酶的活性,这可能在阿尔茨海默病的治疗中得到探索,但这可能被砷引起的肝毒性所抵消。
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引用次数: 19
Beneficial Effects of Teucrium polium and Metformin on Diabetes-Induced Memory Impairments and Brain Tissue Oxidative Damage in Rats. 二甲双胍对糖尿病大鼠记忆损伤和脑组织氧化损伤的有益作用。
Q1 Neuroscience Pub Date : 2015-01-01 Epub Date: 2015-02-24 DOI: 10.1155/2015/493729
S Mojtaba Mousavi, Saeed Niazmand, Mahmoud Hosseini, Zarha Hassanzadeh, Hamid Reza Sadeghnia, Farzaneh Vafaee, Zakieh Keshavarzi

Objective. The effects of hydroalcoholic extract of Teucrium polium and metformin on diabetes-induced memory impairment and brain tissues oxidative damage were investigated. Methods. The rats were divided into: (1) Control, (2) Diabetic, (3) Diabetic-Extract 100 (Dia-Ext 100), (4) Diabetic-Extract 200 (Dia-Ext 200), (5) Diabetic-Extract 400 (Dia-Ext 400), and (6) Diabetic-Metformin (Dia-Met). Groups 3-6 were treated by 100, 200, and 400 mg/kg of the extract or metformin, respectively, for 6 weeks (orally). Results. In passive avoidance test, the latency to enter the dark compartment in Diabetic group was lower than that of Control group (P < 0.01). In Dia-Ext 100, Dia-Ext 200, and Dia-Ext 400 and Metformin groups, the latencies were higher than those of Diabetic group (P < 0.01). Lipid peroxides levels (reported as malondialdehyde, MDA, concentration) in the brain of Diabetic group were higher than Control (P < 0.001). Treatment by all doses of the extract and metformin decreased the MDA concentration (P < 0.01). Conclusions. The results of present study showed that metformin and the hydroalcoholic extract of Teucrium polium prevent diabetes-induced memory deficits in rats. Protection against brain tissues oxidative damage might have a role in the beneficial effects of the extract and metformin.

目标。研究了二甲双胍和水醇提取物对糖尿病大鼠记忆损伤和脑组织氧化损伤的影响。方法。大鼠分为:(1)对照组,(2)糖尿病大鼠,(3)糖尿病提取物100 (Dia-Ext 100),(4)糖尿病提取物200 (Dia-Ext 200),(5)糖尿病提取物400 (Dia-Ext 400),(6)糖尿病二甲双胍(Dia-Met)。3 ~ 6组小鼠分别给予100、200、400 mg/kg提取物或二甲双胍口服,疗程6周。结果。在被动回避试验中,糖尿病组进入暗室潜伏期明显低于对照组(P < 0.01)。Dia-Ext 100、Dia-Ext 200、Dia-Ext 400和二甲双胍组的潜伏期均高于糖尿病组(P < 0.01)。糖尿病组脑内脂质过氧化物水平(报告为丙二醛、丙二醛、浓度)高于对照组(P < 0.001)。各剂量提取物和二甲双胍处理均降低MDA浓度(P < 0.01)。结论。本研究结果表明,二甲双胍和水醇提取物对糖尿病大鼠的记忆缺陷有预防作用。对脑组织氧化损伤的保护可能在提取物和二甲双胍的有益作用中起作用。
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引用次数: 51
Vitamin D and Alzheimer's Disease: Neurocognition to Therapeutics. 维生素D和阿尔茨海默病:从神经认知到治疗。
Q1 Neuroscience Pub Date : 2015-01-01 Epub Date: 2015-08-17 DOI: 10.1155/2015/192747
Anindita Banerjee, Vineet Kumar Khemka, Anirban Ganguly, Debashree Roy, Upasana Ganguly, Sasanka Chakrabarti

Alzheimer's disease (AD), the major cause of dementia worldwide, is characterized by progressive loss of memory and cognition. The sporadic form of AD accounts for nearly 90% of the patients developing this disease. The last century has witnessed significant research to identify various mechanisms and risk factors contributing to the complex etiopathogenesis of AD by analyzing postmortem AD brains and experimenting with animal and cell culture based models. However, the treatment strategies, as of now, are only symptomatic. Accumulating evidences suggested a significant association between vitamin D deficiency, dementia, and AD. This review encompasses the beneficial role of vitamin D in neurocognition and optimal brain health along with epidemiological evidence of the high prevalence of hypovitaminosis D among aged and AD population. Moreover, disrupted signaling, altered utilization of vitamin D, and polymorphisms of several related genes including vitamin D receptor (VDR) also predispose to AD or AD-like neurodegeneration. This review explores the relationship between this gene-environmental influence and long term vitamin D deficiency as a risk factor for development of sporadic AD along with the role and rationale of therapeutic trials with vitamin D. It is, therefore, urgently warranted to further establish the role of this potentially neuroprotective vitamin in preventing and halting progressive neurodegeneration in AD patients.

阿尔茨海默病(AD)是世界范围内痴呆症的主要病因,其特征是记忆力和认知能力的逐渐丧失。散发形式的阿尔茨海默病占近90%的患者发展这种疾病。上个世纪,通过对死后AD大脑的分析以及动物和细胞培养模型的实验,人们进行了大量研究,以确定导致AD复杂发病机制的各种机制和危险因素。然而,到目前为止,治疗策略只是治标不治本。越来越多的证据表明维生素D缺乏、痴呆和AD之间存在显著关联。本文综述了维生素D在神经认知和最佳大脑健康中的有益作用,以及老年和AD人群中维生素D缺乏症高发的流行病学证据。此外,信号中断、维生素D利用的改变以及包括维生素D受体(VDR)在内的几个相关基因的多态性也易导致AD或AD样神经变性。这篇综述探讨了这种基因-环境影响与长期维生素D缺乏作为散发性AD发展的危险因素之间的关系,以及维生素D治疗试验的作用和原理。因此,迫切需要进一步确定这种潜在的神经保护维生素在预防和阻止AD患者进行性神经退行性变中的作用。
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引用次数: 74
Neprilysin is poorly expressed in the prefrontal cortex of aged dogs with cognitive dysfunction syndrome. Neprilysin在患有认知功能障碍综合征的老年狗的前额皮质中表达不良。
Q1 Neuroscience Pub Date : 2014-01-01 Epub Date: 2014-01-06 DOI: 10.1155/2014/483281
Jesús Canudas, Daniel Insua, Leticia Sarasa, Angela González-Martínez, María Luisa Suárez, Germán Santamarina, Pedro Pesini, Manuel Sarasa

Neprilysin (NEP) is the principal amyloid β (A β ) degrading peptidase; this activity may protect against Alzheimer's disease (AD), the most important age-related neurodegenerative process. The aim of this work was to analyze NEP mRNA expression in the frontal cortex of dogs with and without canine cognitive dysfunction syndrome (CDS), which is considered a natural model for AD. Expression of canine cerebral NEP mRNA was assessed by RT-PCR followed by qPCR in young, aged-cognitively unimpaired (CU), and aged-cognitively impaired (CI) dogs. On average, aged-CI dogs showed 80% (P < 0.01) lower expression levels of NEP mRNA than their aged-CU counterparts. Furthermore, the standard deviation of the qPCR measurements was more than 6 times higher in the cognitively healthy animals (young and aged-CU) than in the aged-CI group. Another interesting find is the determination of a positive correlation between NEP expression and the number of cholinergic neurons in basal telencephalon, indicating a probable connection between both events in these types of neurodegeneration processes. These results suggest that high expression levels of NEP might be a protective factor for canine CDS and, most likely, for other A β -associated neurodegenerative diseases, such as AD.

Neprilysin (NEP)是主要的淀粉样蛋白β (A β)降解肽酶;这种活动可以预防阿尔茨海默病(AD),这是最重要的与年龄相关的神经退行性过程。本工作的目的是分析NEP mRNA在患有和未患有犬认知功能障碍综合征(CDS)的狗额叶皮层中的表达,CDS被认为是AD的自然模型。采用RT-PCR和qPCR检测幼犬、认知功能未受损老龄犬(CU)和认知功能受损老龄犬(CI)脑NEP mRNA的表达。平均而言,老龄ci犬的NEP mRNA表达水平比老龄cu犬低80% (P < 0.01)。此外,认知健康的动物(年轻和老年ci组)的qPCR测量的标准偏差比老年ci组高6倍以上。另一个有趣的发现是确定了NEP表达与基底端脑胆碱能神经元数量之间的正相关,这表明在这些类型的神经变性过程中这两个事件之间可能存在联系。这些结果表明,高水平的NEP可能是犬CDS的保护因素,并且很可能是其他与a β相关的神经退行性疾病(如AD)的保护因素。
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引用次数: 7
期刊
International Journal of Alzheimer's Disease
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