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Performance of the Rowland Universal Dementia Assessment Scale in Screening Mild Cognitive Impairment at an Outpatient Setting. 罗兰通用痴呆评估量表在门诊轻度认知障碍筛查中的表现。
IF 2.3 Q2 Medicine Pub Date : 2021-07-30 eCollection Date: 2021-05-01 DOI: 10.1159/000517821
Manchumad Manjavong, Panita Limpawattana, Kittisak Sawanyawisuth

Introduction: Mild cognitive impairment (MCI) is defined as the symptomatic pre-dementia phase on the continuum of cognitive decline. Early recognition and application of potential interventions could prevent or delay the progression to dementia. The Rowland Universal Dementia Assessment Scale (RUDAS) shows good performance in the screening of dementia but has limited data regarding its diagnostic properties in the screening of MCI. The objectives of this study were to assess the psychometric properties of the Thai version of the RUDAS (RUDAS-Thai) in the screening of MCI, identify associated factors for the RUDAS performance, and determine the optimal cutoff point in detecting MCI.

Methods: This was a cross-sectional study conducted from January 2020 to March 2021. Older patients at the outpatient clinic of an internal medicine department at a tertiary care hospital in Thailand were examined. Baseline data were collected, and the RUDAS-Thai was administered to each patient. Afterward, a geriatrician assessed each patient for MCI.

Results: A total of 150 patients were included, of whom 42 cases (28%) had MCI. The overall performance of the test using an area under the receiver operating characteristic curve (AUC) was 0.82 (95% confidence interval 0.75-0.89). At the optimal cutoff point of 25/30, the AUC was 0.76 with sensitivity and specificity of 76.2 and 75%, respectively. The educational level affected the test performance according to regression analysis. For patients with years of education ≤6 and >6, the optimal cutoff points were 25/30 and 26/30, respectively.

Conclusion: The RUDAS-Thai performed well in differentiating patients with MCI from normal cognition; however, it was affected by educational level. A score of 25/30 or lower for persons with ≤6 years of education or 26/30 or lower for persons with higher than 6 years of education is the optimal cutoff point for indication of developing MCI.

轻度认知障碍(MCI)被定义为认知能力持续下降的症状性痴呆前期阶段。早期识别和应用潜在的干预措施可以预防或延缓痴呆症的进展。Rowland通用痴呆评估量表(RUDAS)在筛查痴呆方面表现良好,但其在筛查MCI方面的诊断特性数据有限。本研究的目的是评估泰国版本的RUDAS (RUDAS-Thai)在筛查MCI方面的心理测量特性,确定RUDAS表现的相关因素,并确定检测MCI的最佳截止点。方法:这是一项横断面研究,于2020年1月至2021年3月进行。对泰国一家三级保健医院内科门诊的老年患者进行了检查。收集基线数据,并对每位患者进行RUDAS-Thai治疗。之后,一位老年病专家评估每位患者的轻度认知障碍。结果:共纳入150例患者,其中42例(28%)患有轻度认知损伤。使用受试者工作特征曲线下面积(AUC)的测试的总体性能为0.82(95%置信区间为0.75-0.89)。在最佳截断点25/30时,AUC为0.76,敏感性为76.2,特异性为75%。根据回归分析,受教育程度对测试成绩有影响。对于受教育年限≤6年和>6年的患者,最佳分界点分别为25/30和26/30。结论:RUDAS-Thai在轻度认知障碍患者与正常认知障碍患者的鉴别中有较好的应用价值;然而,受教育程度的影响。对于受教育程度≤6年的人,25/30分或更低,对于受教育程度高于6年的人,26/30分或更低是诊断轻度认知障碍的最佳分界点。
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引用次数: 2
False Memory and Alzheimer's Disease Pathology in Patients with Amnestic Mild Cognitive Impairment: A Study with Amyloid PET. 遗忘性轻度认知障碍患者的错误记忆和阿尔茨海默病病理:淀粉样蛋白PET研究
IF 2.3 Q2 Medicine Pub Date : 2021-06-11 eCollection Date: 2021-05-01 DOI: 10.1159/000516230
Eun-Ji Choi, Bum Joon Kim, Hyung-Ji Kim, Miseon Kwon, Noh Eul Han, Sun-Mi Lee, Sungyang Jo, Sunju Lee, Jae-Hong Lee

Introduction: False memory, observed as intrusion errors or false positives (FPs), is prevalent in patients with Alzheimer's disease, but has yet to be thoroughly investigated in patients with amnestic mild cognitive impairment (a-MCI) with Alzheimer's disease pathology (ADP). We analyzed false versus veridical memory in individuals with a-MCI and measured the utility of false memory for ADP discrimination.

Methods: Patients with a-MCI who received neuropsychological testing and amyloid PET were included. Patients were categorized into "with" and "without ADP" groups according to PET results. Memory tests assessed veridical and false memory, and the verity of patient responses was analyzed. A logistic regression model was used to evaluate false memory efficiency in discriminating ADP, and the sensitivity and specificity at the optimal level were estimated using the receiver-operating characteristic curve.

Results: Thirty-seven ADP and 46 non-ADP patients were enrolled. The ADP group made more FPs in the recognition tests, and their response verity was significantly lower in every delayed memory test. No group difference, however, was observed in the veridical memory. The logistic regression analysis demonstrated that as the FPs increased, the risk of ADP increased 1.31 and 1.36 times in the verbal and visual recognition tests, respectively. The discriminatory accuracy of the FPs was estimated "low" to "moderate" in the visual and verbal recognition, respectively, with an optimal cutoff above 2.5.

Conclusion: Increased false memory was the only feature to discriminate ADP from non-ADP in individuals with a-MCI. Further studies regarding false memory and its mechanism are warranted.

虚假记忆,被观察为侵入错误或假阳性(FPs),在阿尔茨海默病患者中很普遍,但尚未对伴有阿尔茨海默病病理(ADP)的遗忘性轻度认知障碍(a-MCI)患者进行彻底调查。我们分析了a-MCI患者的错误记忆和真实记忆,并测量了错误记忆对ADP辨别的效用。方法:接受神经心理测试和淀粉样蛋白PET检查的a-MCI患者。根据PET结果将患者分为有ADP组和无ADP组。记忆测试评估真实记忆和错误记忆,并分析患者反应的真实性。采用logistic回归模型评价错误记忆在识别ADP中的效率,并利用受体-工作特征曲线估计最佳水平下的敏感性和特异性。结果:纳入37例ADP患者和46例非ADP患者。ADP组在识别测试中做出了更多的FPs,并且在每个延迟记忆测试中他们的反应真实性显著降低。然而,在真实记忆方面没有观察到组间差异。logistic回归分析显示,随着FPs的增加,言语和视觉识别测试中ADP的风险分别增加1.31倍和1.36倍。在视觉和言语识别中,FPs的区分准确度分别为“低”到“中等”,最佳截断值高于2.5。结论:错误记忆的增加是a-MCI患者区分ADP与非ADP的唯一特征。对错误记忆及其机制的进一步研究是必要的。
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引用次数: 1
The Neuroinflammasome in Alzheimer's Disease and Cerebral Stroke. 阿尔茨海默病和脑卒中中的神经炎性体。
IF 2.3 Q2 Medicine Pub Date : 2021-06-10 eCollection Date: 2021-05-01 DOI: 10.1159/000516074
Jong-Hoon Lee, Chul Joong Lee, Jungwuk Park, So Jeong Lee, Su-Hee Choi

Aim/background: This review investigated a patient with Alzheimer's disease (AD) treated with 4,4'-diaminodiphenyl sulfone (DDS) as a neuroinflammasome competitor.

Methods: We monitored AD's progression through numeric clinical staging (NCS) with a new biomarker. NCS was determined by the presence of AD symptoms and neuropsychiatric (NP) symptoms caused by anti-AD (AAD) drugs (D) as a biomarker. We also monitored the function of DDS for stroke in a no-intake emergency state.

Results: By introducing (D), AD's progression was monitored through NCS staging. AAD side effects and neuropsychiatric symptoms were identified. DDS was stopped in patients with stroke with NCS 6 caused by AAD, and it rapidly proceeded to cerebral infarct.

Conclusions: AAD can occasionally exacerbate AD and stroke. DDS can alleviate mild cognitive impairment (MCI), early AD and stroke. We clinically confirmed the role of DDS as a neuroinflammasome competitor after stroke. DDS preserved neuronal survival within 24-55 h in the Seoul Study cohort.

目的/背景:本综述研究了用4,4′-二氨基二苯砜(DDS)作为神经炎性小体竞争对手治疗阿尔茨海默病(AD)患者。方法:我们使用一种新的生物标志物,通过数值临床分期(NCS)监测AD的进展。NCS是通过AD症状和抗AD (AAD)药物(D)引起的神经精神(NP)症状的存在作为生物标志物来确定的。我们还监测了无摄入紧急状态下脑卒中DDS的功能。结果:通过引入(D),通过NCS分期监测AD的进展。确定了AAD的副作用和神经精神症状。AAD引起的NCS 6型脑卒中患者停用DDS,并迅速发展为脑梗死。结论:AAD偶尔会加重AD和脑卒中。DDS可减轻轻度认知障碍(MCI)、早期AD和中风。我们临床证实了DDS作为脑卒中后神经炎性小体竞争者的作用。在首尔研究队列中,DDS可在24-55小时内保存神经元存活。
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引用次数: 15
Commentary for the Elderly in the Pandemic Era. 大流行病时代的老年人评论。
IF 2.3 Q2 Medicine Pub Date : 2021-06-10 eCollection Date: 2021-05-01 DOI: 10.1159/000515926
Asif Khattak, Badar Kanwar, Consolato Sergi, Chul Joong Lee, Jenny Balentine, Jong-Hoon Lee, Jungwuk Park, So Jeong Lee, Su-Hee Choi
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引用次数: 0
Effects of the Sonas Program on Anxiety and Depression in Nursing Home Residents with Dementia: A 6-Month Randomized Controlled Trial. Sonas项目对老年痴呆症患者焦虑和抑郁的影响:一项为期6个月的随机对照试验。
IF 2.3 Q2 Medicine Pub Date : 2021-06-08 eCollection Date: 2021-05-01 DOI: 10.1159/000516804
Alka R Goyal, Knut Engedal, Jūratė Šaltytė Benth, Benedicte Sørensen Strøm

Introduction: There is a dearth of evidence about the effects of Sonas, a multisensory stimulation on people with dementia (PWD). The main aim of this study was to examine the effects of the Sonas program on anxiety and depression in nursing home (NH) residents with dementia.

Methods: In all, 120 PWD ≥65 years of age from 6 NHs were included in a randomized control trial and were allocated to 1 of 3 groups for 24 weeks: a Sonas program group (n = 48), a reading group (n = 32), and a control group (n = 40). One hundred and five participants completed follow-up assessments. Anxiety and depression were assessed by the Rating Anxiety in Dementia (RAID) scale and the Cornell Scale for Depression in Dementia (CSDD), respectively. Generalized linear mixed models were estimated to assess trends in the proportion of participants with anxiety (a RAID score ≥11) and depression (a CSDD score ≥10).

Results: No significant reduction in anxiety from baseline to follow-up was observed in any of the groups. Participants in the Sonas group showed a significant reduction in depression from baseline to 12 weeks (p = 0.001) and from baseline to 24 weeks (p = 0.009).

Conclusion: The Sonas program had no effect on severity of anxiety but a reduction in depressive symptoms was found in PWD.

关于Sonas(一种多感官刺激)对痴呆症患者(PWD)的影响,缺乏证据。本研究的主要目的是检查Sonas计划对养老院(NH)痴呆症患者焦虑和抑郁的影响。方法:将来自6个NHs的120名年龄≥65岁的PWD患者纳入随机对照试验,并将其分为3组中的1组,为期24周:Sonas程序组(n = 48),阅读组(n = 32)和对照组(n = 40)。105名参与者完成了后续评估。焦虑和抑郁分别采用痴呆焦虑评定量表(RAID)和康奈尔痴呆抑郁量表(CSDD)进行评估。估计广义线性混合模型来评估焦虑(RAID评分≥11)和抑郁(CSDD评分≥10)参与者比例的趋势。结果:从基线到随访,在任何一组中都没有观察到焦虑的显著减少。从基线到12周(p = 0.001)和从基线到24周(p = 0.009), Sonas组的参与者的抑郁症显著减少。结论:Sonas计划对焦虑的严重程度没有影响,但在PWD中发现抑郁症状减轻。
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引用次数: 0
Parental Age and the Risk for Alzheimer's Disease in Offspring: Systematic Review and Meta-Analysis. 父母年龄与后代患阿尔茨海默病的风险:系统回顾与元分析》。
IF 1.4 Q4 CLINICAL NEUROLOGY Pub Date : 2021-06-08 eCollection Date: 2021-05-01 DOI: 10.1159/000515523
Natalia Szejko, Pedro Macul Ferreira de Barros, Victor J Avila-Quintero, Adam Lombroso, Michael Howard Bloch

Background: Alzheimer's disease (AD) is the most common cause of dementia worldwide, accounting for 50-75% of all cases. While older maternal and paternal age at childbirth are established risk factors for Down syndrome which is associated with later AD, it is still not entirely clear whether parental age is a risk factor for AD. Previous studies have suggested contradictory findings.

Objectives: We conducted a systematic review and meta-analysis to examine whether parental (maternal and paternal) age at birth was associated with AD and whether individuals born to younger or older parents were at an increased risk for AD.

Methods: Two reviewers searched the electronic database of PubMed for relevant studies. Eligibility for the meta-analysis was based on the following criteria: (1) studies involving patients with AD and an adequate control group, (2) case control or cohort studies, (3) studies investigating parental age. All statistical analyses were completed in STATA/IC version 16.

Results: Eleven studies involving 4,371 participants were included in the systematic review and meta-analysis. Meta-analysis demonstrated no significant association between maternal (weighted mean difference [WMD] 0.49, 95% CI -0.52 to 1.49, p = 0.34) and paternal age and AD (WMD 1.00, 95% CI -0.55 to 2.56, p = 0.21). Similarly, individuals born to younger (<25 years) or older parents (>35 years) did not demonstrate a differential risk for AD.

Conclusions: Overall, this meta-analysis did not demonstrate an association between parental age and the risk of AD in offspring. These findings should be interpreted with caution given the limited power of the overall meta-analysis and the methodological limitations of the underlying studies as in many cases no adjustment for potential confounders was included.

背景:阿尔茨海默病(AD)是全球最常见的痴呆症病因,占所有病例的 50-75%。虽然唐氏综合征的母亲和父亲生育时的年龄较大已被确定为风险因素,而唐氏综合征与日后的阿兹海默症有关,但父母的年龄是否是阿兹海默症的风险因素仍不完全清楚。以往的研究结果相互矛盾:我们进行了一项系统综述和荟萃分析,研究父母(母亲和父亲)的出生年龄是否与注意力缺失症有关,以及父母年龄较小或较大的个体患注意力缺失症的风险是否会增加:两名审稿人在 PubMed 电子数据库中搜索了相关研究。荟萃分析的资格基于以下标准:(1)涉及 AD 患者和适当对照组的研究;(2)病例对照或队列研究;(3)调查父母年龄的研究。所有统计分析均在 STATA/IC 16 版本中完成:系统综述和荟萃分析共纳入了 11 项研究,涉及 4371 名参与者。荟萃分析表明,母亲年龄(加权平均差 [WMD] 0.49,95% CI -0.52至1.49,p = 0.34)和父亲年龄(WMD 1.00,95% CI -0.55至2.56,p = 0.21)与注意力缺失症之间无明显关联。同样,较年轻(35 岁)出生的个体也没有显示出不同的注意力缺失症风险:总体而言,这项荟萃分析并未证明父母年龄与后代罹患先天性痴呆症的风险之间存在关联。考虑到总体荟萃分析的有限性以及相关研究在方法上的局限性,在解释这些发现时应谨慎,因为在很多情况下没有对潜在的混杂因素进行调整。
{"title":"Parental Age and the Risk for Alzheimer's Disease in Offspring: Systematic Review and Meta-Analysis.","authors":"Natalia Szejko, Pedro Macul Ferreira de Barros, Victor J Avila-Quintero, Adam Lombroso, Michael Howard Bloch","doi":"10.1159/000515523","DOIUrl":"10.1159/000515523","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is the most common cause of dementia worldwide, accounting for 50-75% of all cases. While older maternal and paternal age at childbirth are established risk factors for Down syndrome which is associated with later AD, it is still not entirely clear whether parental age is a risk factor for AD. Previous studies have suggested contradictory findings.</p><p><strong>Objectives: </strong>We conducted a systematic review and meta-analysis to examine whether parental (maternal and paternal) age at birth was associated with AD and whether individuals born to younger or older parents were at an increased risk for AD.</p><p><strong>Methods: </strong>Two reviewers searched the electronic database of PubMed for relevant studies. Eligibility for the meta-analysis was based on the following criteria: (1) studies involving patients with AD and an adequate control group, (2) case control or cohort studies, (3) studies investigating parental age. All statistical analyses were completed in STATA/IC version 16.</p><p><strong>Results: </strong>Eleven studies involving 4,371 participants were included in the systematic review and meta-analysis. Meta-analysis demonstrated no significant association between maternal (weighted mean difference [WMD] 0.49, 95% CI -0.52 to 1.49, <i>p</i> = 0.34) and paternal age and AD (WMD 1.00, 95% CI -0.55 to 2.56, <i>p</i> = 0.21). Similarly, individuals born to younger (<25 years) or older parents (>35 years) did not demonstrate a differential risk for AD.</p><p><strong>Conclusions: </strong>Overall, this meta-analysis did not demonstrate an association between parental age and the risk of AD in offspring. These findings should be interpreted with caution given the limited power of the overall meta-analysis and the methodological limitations of the underlying studies as in many cases no adjustment for potential confounders was included.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216010/pdf/dee-0011-0140.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39113935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early Detection and Intervention for Patients with Delirium Admitted to the Department of Internal Medicine: Lessons from a Pilot Initiative. 内科住院谵妄患者的早期发现和干预:试点项目的经验教训。
IF 2.3 Q2 Medicine Pub Date : 2021-06-02 eCollection Date: 2021-05-01 DOI: 10.1159/000515958
Ron Oliven, Meital Rotfeld, Sharon Gino-Moor, Elad Schiff, Majed Odeh, Efrat Gil

Introduction: Older patients who arrive to the emergency room with delirium have a worse prognosis than others. Early detection and treatment of this problem has been shown to improve outcome. We have launched a project at our hospital to improve the care of patients who arrive delirious to the medical emergency room. The present article describes lessons that can be learned from this pilot initiative.

Methods: All patients older than 70 years admitted to the department of internal medicine were screened for delirium in the emergency room using the 4AT screening tool. Data of patients with a 4AT score ≥5 (or with incomplete score) were transferred to the geriatric unit of the hospital. On the ward, the presence of delirium was confirmed by a geriatric nurse that validated that the patient could walk with support and ordered mobilization and physiotherapy (M&P).

Results: Over the 2 and a half years (10 quarters) allocated for the pilot project, 1,078 medical patients with delirium were included in this survey. In 59.3%, the diagnosis of delirium could be confirmed only after admission. Due to budgetary constraints, only 54.7% received the allocated specific intervention - early M&P. Since it was decided that randomization was not appropriate for our initiative, we found that patients who received M&P had lower (better) 4AT scores on admission, and lower mortality. No significant difference was found between the patients who received M&P and the others in length of hospitalization and discharge to nursing homes. Retrospective comparison of the two groups did not enable to determine whether M&P was given to the patients for whom it was most effective.

Conclusions: It is often not possible to verify in the emergency room that the cognitive decline is indeed new, that is, is due to delirium, and measures must be taken to verify this point as soon as possible after admission. Due to numerous constraints, the availability of early M&P is often insufficient. Whenever resources are scarce and randomization is avoided, adequate criteria should be found for allocating existing dedicated staff to patients for whom early mobilization is likely to be most beneficial.

老年谵妄患者到急诊室的预后比其他患者差。这一问题的早期发现和治疗已被证明可以改善结果。我们在医院启动了一个项目,以改善对神志不清的病人的护理。本文描述了可以从这个试点项目中学到的经验教训。方法:所有年龄大于70岁的内科住院患者在急诊室使用4AT筛查工具筛查谵妄。4AT评分≥5分(或评分不完整)的患者数据被转移到医院的老年科。在病房,一位老年护士确认了谵妄的存在,并确认患者可以在支持下行走,并下令进行活动和物理治疗(M&P)。结果:在两年半(10个季度)的试点时间里,共纳入1078名谵妄患者。入院后才确诊谵妄的占59.3%。由于预算限制,只有54.7%的人接受了分配的具体干预措施-早期M&P。由于决定随机化不适合我们的倡议,我们发现接受M&P的患者入院时的4AT评分较低(更好),死亡率较低。在住院时间和出院时间方面,接受M&P治疗的患者与其他患者无显著差异。回顾性比较两组不能确定是否给予患者M&P是最有效的。结论:在急诊室往往无法证实认知能力下降确实是新的,即由于谵妄,必须在入院后尽快采取措施证实这一点。由于许多限制,早期M&P的可用性往往是不足的。每当资源稀缺和避免随机化时,应找到适当的标准,将现有的专职人员分配给早期动员可能最有益的患者。
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引用次数: 1
Cognitive Profile of Patients with Thalamic Hemorrhage according to Lesion Localization. 丘脑出血患者根据病变定位的认知特征。
IF 2.3 Q2 Medicine Pub Date : 2021-05-27 eCollection Date: 2021-05-01 DOI: 10.1159/000516439
Musa Temel, Busra S A Polat, Nuriye Kayali, Omer Karadas

Background: The thalamus is known as the central sensory and motor relay station of the brain generally. However, cognitive decline due to thalamic lesions has been previously reported in different studies. Also, it has been observed that different cognitive subdomains are affected according to the localization of the lesion in the thalamus.

Objectives and methods: Detailed neurophysiological tests were performed on 28 patients with thalamic hemorrhage and the control group. Patients were grouped according to lesion localization. The results were compared with both the control group and the hemorrhage groups themselves.

Results: The performance of patients in all neuropsychological tests was significantly worse than that of the control group. Of the 28 patients, 15 had anterolateral, 5 had posterolateral, 5 had dorsal, and 3 had an anteromedial thalamic hemorrhage. The anteromedial group had the worst scores of almost all tests. Also, 2 situations came to notice in these tests. First, the posterolateral group achieved a remarkably low mean in the recall subgroup of the MMSE tests and verbal memory process tests. Second, the anterolateral group was found to have a low mean in both the language subgroup of the MMSE tests and the phonemic subgroup of the verbal fluency tests.

Conclusion: It was concluded in this study that thalamic hemorrhages affect cognition entirely regardless of the lesion localization. It was also observed that the lateral part of the thalamus was associated with language, the posterior part with memory, and the anteromedial part with the rest of the cognitive subdomains.

背景:丘脑通常被称为大脑的中枢感觉和运动中继站。然而,丘脑损伤导致的认知能力下降以前在不同的研究中都有报道。此外,已经观察到不同的认知亚域根据丘脑中病变的定位而受到影响。目的和方法:对28例丘脑出血患者和对照组进行详细的神经生理学检查。根据病变部位对患者进行分组。将结果与对照组和出血组本身进行比较。结果:患者在所有神经心理测试中的表现均明显低于对照组。在28例患者中,15例为前外侧,5例为后外侧,5名为背侧,3例为前内侧丘脑出血。在几乎所有测试中,前内侧组的得分最差。此外,在这些测试中注意到了两种情况。首先,在MMSE测试和言语记忆过程测试的回忆亚组中,后外侧组的平均值显著较低。其次,前外侧组在MMSE测试的语言亚组和语言流利性测试的音素亚组中的平均值均较低。结论:本研究得出的结论是,丘脑出血完全影响认知,而与病变部位无关。还观察到丘脑的外侧部分与语言有关,后部与记忆有关,前内侧部分与其他认知子域有关。
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引用次数: 2
Decreased Time on the Nondominant One-Leg Standing Test Associated with Repeated Falls in Older Residents with Healthy Aging, Mild Cognitive Impairment, and Dementia: The Wakuya Project. 在健康老龄化、轻度认知障碍和痴呆的老年居民中,非优势单腿站立测试时间减少与重复跌倒相关:Wakuya项目。
IF 2.3 Q2 Medicine Pub Date : 2021-05-21 eCollection Date: 2021-05-01 DOI: 10.1159/000516360
Keiichi Kumai, Mika Kumai, Junko Takada, Jiro Oonuma, Kei Nakamura, Kenichi Meguro

Introduction: The aim of this study is to clarify the association between repeated falls and the dominant/nondominant side in the open-eyed one-leg standing (OLS) test among people who are healthy or have mild cognitive impairment (MCI) or dementia in a community setting. We recruited 180 participants from 39 areas in the town of Wakuya.

Methods: This is a cross-sectional study. Participants were classified into 3 Clinical Dementia Rating (CDR) groups, i.e., CDR 0 (healthy, n = 71), CDR 0.5 (MCI, n = 85), and CDR 1+ (n = 23), and they were investigated for motor function (grip strength, 6-m normal gait speed, timed up and go test, and OLS test) and falls during the past year.

Results: Subjects with a CDR of 0.5 had higher rates of single and repeated falls (13.0 and 23.4%, respectively) than the CDR 0 group (12.1 and 4.5%, respectively), as did those in CDR 1+ group (15.0 and 30.0%). For the CDR 0.5 group, the frequency of falls was negatively (biologically meaningful direction) correlated with the left OLS time. No significant correlations with falls were found for other motor function tests. Another analysis separating the CDR 0.5 group into 2 subgroups (repeated falls vs. no or a single fall) also showed that the left OLS time was lower in subjects with repeated falls.

Conclusion: People with MCI who had fallen repeatedly in the year before the assessment had a significantly lower left OLS time compared to those who had not fallen or had had 1 fall with MCI. None of the other physical measures were associated with past repeat falls including OLS on the dominant right side. No such findings were noted in the CDR 0 and CDR 0+ groups.

简介:本研究的目的是澄清在社区环境中健康或轻度认知障碍(MCI)或痴呆的人群中,反复跌倒与睁眼单腿站立(OLS)测试中优势/非优势侧之间的关系。我们从Wakuya镇的39个地区招募了180名参与者。方法:这是一个横断面研究。参与者被分为3个临床痴呆评分(CDR)组,即CDR 0(健康,n = 71), CDR 0.5 (MCI, n = 85)和CDR 1+ (n = 23),并调查了他们在过去一年中的运动功能(握力,6米正常步态速度,计时起来和走测试,OLS测试)和跌倒。结果:CDR为0.5的受试者的单次和重复跌倒率(分别为13.0%和23.4%)高于CDR 0组(分别为12.1%和4.5%),CDR 1+组(分别为15.0%和30.0%)也是如此。对于CDR 0.5组,跌倒频率与左OLS时间呈负相关(具有生物学意义的方向)。其他运动功能测试未发现与跌倒有显著相关性。另一项分析将CDR 0.5组分为2个亚组(重复跌倒与不跌倒或单次跌倒),也表明重复跌倒的受试者的左OLS时间更短。结论:在评估前一年多次跌倒的MCI患者的左OLS时间明显低于没有跌倒或有1次跌倒的MCI患者。没有其他物理测量与过去的重复跌倒有关,包括主要右侧的OLS。在CDR 0和CDR 0+组中未见此类发现。
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引用次数: 2
Maintenance of the Amygdala-Hippocampal Circuit Function with Safe and Feasible Shaking Exercise Therapy in SAMP-10 Mice. 安全可行的震动运动疗法对SAMP-10小鼠杏仁核-海马回路功能的维持
IF 2.3 Q2 Medicine Pub Date : 2021-05-19 eCollection Date: 2021-05-01 DOI: 10.1159/000515957
Runhong Yao, Kazuhiro Nishii, Naoki Aizu, Takumi Kito, Kazuyoshi Sakai, Kouji Yamada

Introduction: Patients with dementia show reduced adaptive, behavioral, and physiological responses to environmental threats. Physical exercise is expected to delay brain aging, maintain cognitive function and, consequently, help dementia patients face threats and protect themselves skillfully.

Methods: To confirm this, we aimed to investigate the effects of the shaking exercise on the avoidance function in the senescence-accelerated mouse-prone strain-10 (SAMP-10) model at the behavioral and tissue levels. SAMP-10 mice were randomized into 2 groups: a control group and a shaking group. The avoidance response (latency) of the mice was evaluated using a passive avoidance task. The degree of amygdala and hippocampal aging was evaluated based on the brain morphology. Subsequently, the association between avoidance response and the degree of amygdala-hippocampal aging was evaluated.

Results: Regarding the passive avoidance task, the shaking group showed a longer latency period than the control group (p < 0.05), even and low intensity staining of ubiquitinated protein, and had a higher number of and larger neurons than those of the control group. The difference between the groups was more significant in the BA region of the amygdala and the CA1 region of the hippocampus (staining degree: p < 0.05, neuron size: p < 0.01, neuron counts: p < 0.01) than in other regions.

Conclusions: The shaking exercise prevents nonfunctional protein (NFP) accumulation, neuron atrophy, and neuron loss; delays the aging of the amygdala and hippocampus; and maintains the function of the amygdala-hippocampal circuit. It thus enhances emotional processing and cognition functions, the memory of threats, the skillful confrontation of threats, and proper self-protection from danger.

引言:痴呆症患者对环境威胁的适应、行为和生理反应减弱。体育锻炼有望延缓大脑衰老,保持认知功能,从而帮助痴呆症患者面对威胁并巧妙地保护自己。方法:为了证实这一点,我们旨在从行为和组织水平上研究摇晃运动对衰老加速小鼠倾向性菌株10(SAMP-10)模型回避功能的影响。SAMP-10小鼠随机分为2组:对照组和摇动组。使用被动回避任务评估小鼠的回避反应(潜伏期)。根据大脑形态学评估杏仁核和海马的衰老程度。随后,评估了回避反应与杏仁核-海马衰老程度之间的关系。结果:在被动回避任务方面,摇晃组表现出比对照组更长的潜伏期(p<0.05),泛素化蛋白染色均匀且低强度,神经元数量和体积比对照组更多。两组之间的差异在杏仁核BA区和海马CA1区(染色程度:p<0.05,神经元大小:p<0.01,神经元计数:p<0.01)比其他区域更显著。结论:摇动运动可防止非功能蛋白(NFP)积累、神经元萎缩和神经元丢失;延缓杏仁核和海马体的衰老;并维持杏仁核-海马回路的功能。从而增强情绪处理和认知功能,增强对威胁的记忆,熟练对抗威胁,以及适当的自我保护。
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引用次数: 4
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Dementia and Geriatric Cognitive Disorders Extra
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