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Urinary Apolipoprotein C3 Is a Potential Biomarker for Alzheimer's Disease. 尿载脂蛋白C3是阿尔茨海默病的潜在生物标志物。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-09-11 eCollection Date: 2020-09-01 DOI: 10.1159/000509561
Yumi Watanabe, Yoshitoshi Hirao, Kensaku Kasuga, Takayoshi Tokutake, Kaori Kitamura, Shumpei Niida, Takeshi Ikeuchi, Kazutoshi Nakamura, Tadashi Yamamoto

Introduction: Biomarkers of Alzheimer's disease (AD) that can easily be measured in routine health checkups are desirable. Urine is a source of biomarkers that can be collected easily and noninvasively. We previously reported on the comprehensive profile of the urinary proteome of AD patients and identified proteins estimated to be significantly increased or decreased in AD patients by a label-free quantification method. The present study aimed to validate urinary levels of proteins that significantly differed between AD and control samples from our proteomics study (i.e., apolipoprotein C3 [ApoC3], insulin-like growth factor-binding protein 3 [Igfbp3], and apolipoprotein D [ApoD]).

Methods: Enzyme-linked immunosorbent assays (ELISAs) were performed using urine samples from the same patient and control groups analyzed in the previous proteomics study (18 AD and 18 controls, set 1) and urine samples from an independent group of AD patients and controls (13 AD, 5 mild cognitive impairment [MCI], and 32 controls) from the National Center for Geriatrics and Gerontology Biobank (set 2).

Results: In set 1, the crude urinary levels of ApoD, Igfbp3, and creatinine-adjusted ApoD were significantly higher in the AD group relative to the control group (p = 0.003, p = 0.002, and p = 0.019, respectively), consistent with our previous proteomics results. In set 2, however, the crude urinary levels of Igfbp3 were significantly lower in the AD+MCI group than in the control group (p = 0.028), and the levels of ApoD and ApoC3 did not differ significantly compared to the control group. Combined analysis of all samples revealed creatinine-adjusted ApoC3 levels to be significantly higher in the AD+MCI group (p = 0.015) and the AD-only group (p = 0.011) relative to the control group.

Conclusion: ApoC3 may be a potential biomarker for AD, as validated by ELISA. Further analysis of ApoC3 as a urinary biomarker for AD is warranted.

简介:阿尔茨海默病(AD)的生物标志物,可以很容易地测量在常规健康检查是可取的。尿液是一种生物标志物的来源,可以很容易和无创地收集。我们之前报道了AD患者尿蛋白质组的综合概况,并通过无标记量化方法确定了AD患者中估计显着增加或减少的蛋白质。本研究旨在验证AD患者尿液中的蛋白质水平与我们蛋白质组学研究的对照样本之间的显著差异(即载脂蛋白C3 [ApoC3],胰岛素样生长因子结合蛋白3 [Igfbp3]和载脂蛋白D [ApoD])。方法:酶联免疫吸附测定(elisa)使用来自先前蛋白质组学研究中分析的同一患者和对照组的尿液样本(18例AD和18例对照,组1)和来自国家老年医学和老年生物学生物库的独立组AD患者和对照组的尿液样本(13例AD, 5例轻度认知障碍[MCI]和32例对照)(组2)。在set 1中,AD组的粗尿ApoD、Igfbp3和肌酐调节ApoD水平明显高于对照组(p = 0.003、p = 0.002和p = 0.019),与我们之前的蛋白质组学结果一致。然而,在第2组中,AD+MCI组的尿中Igfbp3粗水平显著低于对照组(p = 0.028), ApoD和ApoC3的水平与对照组相比无显著差异。所有样本的综合分析显示,相对于对照组,AD+MCI组(p = 0.015)和AD单独组(p = 0.011)的肌酐调节apop3水平显著高于对照组。结论:经ELISA验证,ApoC3可能是AD的潜在生物标志物。进一步分析apo3作为阿尔茨海默病的尿液生物标志物是有必要的。
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引用次数: 14
Apathy in Alzheimer's Disease Correlates with the Dopamine Transporter Level in the Caudate Nuclei. 阿尔茨海默病的冷漠与尾状核多巴胺转运蛋白水平相关。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-09-09 eCollection Date: 2020-05-01 DOI: 10.1159/000509278
Niki Udo, Naoki Hashimoto, Takuya Toyonaga, Tomoyuki Isoyama, Yuka Oyanagi, Hisashi Narita, Tohru Shiga, Shin Nakagawa, Ichiro Kusumi

Introduction: Apathy is a common neuropsychiatric symptom in patients with Alzheimer's disease (AD). The striatal binding potential (BP) of 123I-FP-CIT (N-δ-fluoropropyl-2β-carbomethoxy-3β-[4-iodophenyl]tropane) single-photon emission computed tomography (SPECT) is correlated with the degree of apathy in patients with Parkinson's disease (PD) and dementia with Lewy bodies (DLB). This study aimed to determine if dopaminergic activity in the basal ganglia is associated with the development of apathy in AD.

Methods: Nineteen subjects with AD were included and underwent 123I-FP-CIT-SPECT. Patients with other types of dementia as a comorbidity, those taking antidepressants, and those with overt parkinsonism were excluded. Apathy was assessed using the Apathy Evaluation Scale Informant-Japanese version (AES-I-J). SPECT images were overlaid with images in striatal regions of interest (ROIs), and the SPECT values in these regions were counted. The relationship between BP values and AES-I-J scores was investigated using Spearman's rank correlation coefficient.

Results: Significant inverse correlations were observed between BP values and AES-I-J scores in the left caudate nucleus and there was a marginally significant inverse correlation in the right caudate nucleus.

Conclusion: The pathological basis of apathy might be the impairment of the dopaminergic nervous system. Further studies on more subjects with AD, healthy controls, and patients with PD and DLB are needed.

冷漠是阿尔茨海默病(AD)患者常见的神经精神症状。123I-FP-CIT (N-δ-氟丙基-2β-碳甲氧基-3β-[4-碘苯基]tropane)单光子发射计算机断层扫描(SPECT)纹状体结合电位(BP)与帕金森病(PD)和路易体痴呆(DLB)患者的冷漠程度相关。本研究旨在确定基底神经节的多巴胺能活性是否与阿尔茨海默病冷漠的发展有关。方法:19例AD患者行123I-FP-CIT-SPECT检查。同时伴有其他类型痴呆的患者、服用抗抑郁药的患者和有明显帕金森病的患者均被排除在外。冷漠评估采用日本版冷漠评估量表(AES-I-J)。在纹状体感兴趣区域(ROIs)上叠加SPECT图像,并对这些区域的SPECT值进行计数。采用Spearman等级相关系数研究BP值与AES-I-J评分之间的关系。结果:左尾状核BP值与AES-I-J评分呈显著负相关,右尾状核BP值与AES-I-J评分呈极显著负相关。结论:冷漠的病理基础可能是多巴胺能神经系统的损伤。需要对更多的AD患者、健康对照者以及PD和DLB患者进行进一步的研究。
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引用次数: 14
Vegetable Freshness Perception in Dementia with Lewy Bodies and Alzheimer's Disease. 路易体痴呆和阿尔茨海默病的蔬菜新鲜度感知。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-08-06 eCollection Date: 2020-05-01 DOI: 10.1159/000508282
Yuka Oishi, Toru Imamura, Tatsuo Shimomura, Kyoko Suzuki

Introduction: Although various visual function deficits have been reported in patients with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), vegetable freshness perception has not been thoroughly examined.

Objective: To investigate vegetable freshness perception in patients with AD and DLB and to clarify the relationship between vegetable freshness perception and various visuoperceptual functions.

Methods: We enrolled 37 patients with probable DLB, 58 patients with probable AD, and 32 age-matched healthy controls. We assessed vegetable freshness perception and visuoperceptual functions, including vegetable brightness perception, contrast sensitivity, color perception, and stereopsis. Patients with DLB showed disproportionate deficits in vegetable freshness perception and vegetable luminance perception compared to patients with AD and controls. Analyses of the groups with higher and lower vegetable freshness perceptions revealed significant differences in contrast sensitivity and visual texture recognition.

Results: In the vegetable freshness test, we found significant differences among the 3 groups (F = 30.029, p < 0.0001); the extent of impairment in patients with DLB was greater than that in patients with AD. In patients with DLB, the vegetable freshness judgments were significantly correlated with texture judgment scores and contrast sensitivity.

Conclusion: Our findings revealed significantly impaired vegetable freshness perception in patients with DLB. Vegetable freshness perception may be related to visual texture recognition in patients with DLB.

导语:虽然阿尔茨海默病(AD)和路易体痴呆(DLB)患者有各种视觉功能缺陷的报道,但蔬菜新鲜度感知尚未得到彻底的检查。目的:探讨AD和DLB患者的蔬菜新鲜度知觉,阐明蔬菜新鲜度知觉与各种视知觉功能的关系。方法:我们招募了37名可能患有DLB的患者,58名可能患有AD的患者和32名年龄匹配的健康对照。我们评估了蔬菜新鲜度感知和视觉感知功能,包括蔬菜亮度感知、对比敏感度、颜色感知和立体视觉。与AD患者和对照组相比,DLB患者在蔬菜新鲜度和蔬菜亮度感知方面表现出不成比例的缺陷。对蔬菜新鲜度感知较高和较低的组的分析显示,对比敏感度和视觉纹理识别存在显著差异。结果:在蔬菜新鲜度测试中,3组间差异有统计学意义(F = 30.029, p < 0.0001);DLB患者的损伤程度大于AD患者。在DLB患者中,蔬菜新鲜度判断与质地判断评分和对比敏感度显著相关。结论:我们的研究结果显示,DLB患者对蔬菜新鲜度的感知明显受损。蔬菜新鲜度感知可能与DLB患者的视觉纹理识别有关。
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引用次数: 0
Cognitive Reserve Moderates the Predictive Role of Memory Complaints for Subsequent Decline in Executive Functioning. 认知储备调节记忆抱怨对随后执行功能下降的预测作用。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-07-16 eCollection Date: 2020-05-01 DOI: 10.1159/000508363
Andreas Ihle, Élvio R Gouveia, Bruna R Gouveia, Matthias Kliegel

Aims: We investigated whether the longitudinal relation between memory complaints and subsequent decline in executive functioning over 6 years differed by leisure activity engagement as major contributor to cognitive reserve in old age.

Methods: We analyzed longitudinal data from 897 older adults (M = 74.33 years) tested on the Trail Making Test (TMT) in two waves 6 years apart. Participants reported information on memory complaints and leisure activity engagement.

Results: There was a significant interaction of memory complaints with leisure activity engagement on latent change in executive functioning. Specifically, only for individuals with less (but not those with greater) leisure activity engagement, memory complaints significantly predicted a steeper subsequent decline in executive functioning across 6 years (i.e., increases in TMT completion time).

Conclusion: The role of memory complaints as an early predictor of decline in executive functioning seems to vary by individuals' cognitive reserve.

目的:我们调查了记忆抱怨与随后的执行功能下降之间的纵向关系是否因休闲活动参与作为老年认知储备的主要贡献者而有所不同。方法:我们对897名老年人(M = 74.33岁)的纵向数据进行了分析,这些老年人分两波进行了追踪测试(TMT),间隔6年。参与者报告了关于记忆抱怨和休闲活动参与的信息。结果:记忆抱怨与休闲活动参与对执行功能的潜在变化有显著的交互作用。具体来说,只有休闲活动参与较少的个体(而不是休闲活动参与较多的个体),记忆抱怨显著预测了6年内执行功能的急剧下降(即TMT完成时间的增加)。结论:记忆抱怨作为执行功能下降的早期预测因素的作用似乎因个体的认知储备而异。
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引用次数: 3
Utility of Easy Z-Score Imaging System-Assisted SPECT in Detecting Onset Age-Dependent Decreases in Cerebral Blood Flow in the Posterior Cingulate Cortex, Precuneus, and Parietal Lobe in Alzheimer's Disease with Amyloid Accumulation. 利用Easy Z-Score成像系统辅助SPECT检测淀粉样蛋白堆积的阿尔茨海默病后扣带皮层、楔前叶和顶叶脑血流的年龄依赖性减少。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-06-10 eCollection Date: 2020-05-01 DOI: 10.1159/000507654
Hiroshi Hayashi, Ryota Kobayashi, Shinobu Kawakatsu, Daichi Morioka, Koichi Otani

Background: Easy Z-score imaging system (eZIS)-assisted SPECT accurately detects decreases in cerebral blood flow in the posterior cingulate cortex (PCC), precuneus, and parietal lobe, the cerebral regions deeply implicated in Alzheimer's disease (AD). Several studies suggested onset age-dependent decreases in cerebral blood flow in these regions in AD, but these studies did not screen for amyloid accumulation, suggesting inclusion of non-AD patients in their subjects.

Objective: By applying eZIS-SPECT to patients with amyloid deposition, it was the aim of this study to clarify onset age-dependent decreases in cerebral blood flow in the regions critical to AD.

Methods: We retrospectively analyzed eZIS-SPECT data on 34 AD patients with amyloid retention confirmed by 11C-Pittsburgh compound B-PET. The subjects were divided into an early-onset group (n = 16) and a late-onset group (n = 18). The three indicators of the eZIS that had discriminated between AD patients and normal controls in previous studies were compared between the two groups.

Results: The mean values for the respective indicators were significantly higher in the early-onset group than in the late-onset group. Also, the proportion of patients with abnormalities in all indicators was significantly higher in the early-onset group (93.8%) than in the late-onset group (50.0%).

Conclusions: The present study, applying eZIS-SPECT to amyloid-positive AD patients, suggests that reduced cerebral blood flow in the PCC, precuneus, and parietal lobe is more pronounced in the early-onset type than in the late-onset type of the disease.

背景:Easy Z-score成像系统(eZIS)辅助SPECT准确检测脑后扣带皮层(PCC)、楔前叶和顶叶的脑血流减少,这些大脑区域与阿尔茨海默病(AD)有密切关系。几项研究表明,阿尔茨海默病患者发病时,这些区域的脑血流量随年龄而减少,但这些研究没有筛查淀粉样蛋白积累,这表明非阿尔茨海默病患者也包括在研究对象中。目的:通过对淀粉样蛋白沉积患者应用eZIS-SPECT,本研究的目的是阐明AD关键区域脑血流量的发病年龄依赖性减少。方法:回顾性分析34例经11C-Pittsburgh复合B-PET证实淀粉样蛋白滞留的AD患者的eZIS-SPECT数据。研究对象分为早发型组(n = 16)和晚发型组(n = 18)。比较以往研究中区分AD患者与正常对照的eZIS三项指标。结果:早发组各项指标的平均值明显高于晚发组。各指标异常的患者比例早发型组(93.8%)明显高于晚发型组(50.0%)。结论:本研究将eZIS-SPECT应用于淀粉样蛋白阳性AD患者,表明早发型AD患者的PCC、楔前叶和顶叶脑血流量减少比晚发型AD患者更为明显。
{"title":"Utility of Easy <i>Z</i>-Score Imaging System-Assisted SPECT in Detecting Onset Age-Dependent Decreases in Cerebral Blood Flow in the Posterior Cingulate Cortex, Precuneus, and Parietal Lobe in Alzheimer's Disease with Amyloid Accumulation.","authors":"Hiroshi Hayashi,&nbsp;Ryota Kobayashi,&nbsp;Shinobu Kawakatsu,&nbsp;Daichi Morioka,&nbsp;Koichi Otani","doi":"10.1159/000507654","DOIUrl":"https://doi.org/10.1159/000507654","url":null,"abstract":"<p><strong>Background: </strong>Easy <i>Z</i>-score imaging system (eZIS)-assisted SPECT accurately detects decreases in cerebral blood flow in the posterior cingulate cortex (PCC), precuneus, and parietal lobe, the cerebral regions deeply implicated in Alzheimer's disease (AD). Several studies suggested onset age-dependent decreases in cerebral blood flow in these regions in AD, but these studies did not screen for amyloid accumulation, suggesting inclusion of non-AD patients in their subjects.</p><p><strong>Objective: </strong>By applying eZIS-SPECT to patients with amyloid deposition, it was the aim of this study to clarify onset age-dependent decreases in cerebral blood flow in the regions critical to AD.</p><p><strong>Methods: </strong>We retrospectively analyzed eZIS-SPECT data on 34 AD patients with amyloid retention confirmed by <sup>11</sup>C-Pittsburgh compound B-PET. The subjects were divided into an early-onset group (<i>n</i> = 16) and a late-onset group (<i>n</i> = 18). The three indicators of the eZIS that had discriminated between AD patients and normal controls in previous studies were compared between the two groups.</p><p><strong>Results: </strong>The mean values for the respective indicators were significantly higher in the early-onset group than in the late-onset group. Also, the proportion of patients with abnormalities in all indicators was significantly higher in the early-onset group (93.8%) than in the late-onset group (50.0%).</p><p><strong>Conclusions: </strong>The present study, applying eZIS-SPECT to amyloid-positive AD patients, suggests that reduced cerebral blood flow in the PCC, precuneus, and parietal lobe is more pronounced in the early-onset type than in the late-onset type of the disease.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"10 2","pages":"63-68"},"PeriodicalIF":2.3,"publicationDate":"2020-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000507654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245272","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: 7
Stability of Plasma Amyloid-β 1-40, Amyloid-β 1-42, and Total Tau Protein over Repeated Freeze/Thaw Cycles. 血浆淀粉样蛋白-β 1-40、淀粉样蛋白-β 1-42和总Tau蛋白在反复冻融循环中的稳定性
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-01-01 DOI: 10.1159/000506278
Huei-Chun Liu, Ming-Jang Chiu, Chin-Hsien Lin, Shieh-Yueh Yang

Introduction: Blood biomarkers of Alzheimer's disease (AD) have attracted much attention of researchers in recent years. In clinical studies, repeated freeze/thaw cycles often occur and may influence the stability of biomarkers. This study aims to investigate the stability of amyloid-β 1-40 (Aβ1-40), amyloid-β 1-42 (Aβ1-42), and total tau protein (T-tau) in plasma over freeze/thaw cycles.

Methods: Plasma samples from healthy controls (n = 2), AD patients (AD, n =3) and Parkinson's disease patients (PD, n = 3) were collected by standardized procedure and immediately frozen at -80°C. Samples underwent 5 freeze/thaw (-80°C/room temperature) cycles. The concentrations of Aβ1-40, Aβ1-42, and T-tau were monitored during the freeze/thaw tests using an immunomagnetic reduction (IMR) assay. The relative percentage of concentrations after every freeze/thaw cycle was calculated for each biomarker.

Results: A tendency of decrease in the averaged relative percentages over samples through the freeze and thaw cycles for Aβ1-40 (100 to 97.11%), Aβ1-42 (100 to 94.99%), and T-tau (100 to 95.65%) was found. However, the decreases were less than 6%. For all three biomarkers, no statistical significance was found between the levels of fresh plasma and those of the plasma experiencing 5 freeze/thaw cycles (p > 0.1).

Conclusions: Plasma Aβ1-40, Aβ1-42, and T-tau are stable through 5 freeze/thaw cycles measured with IMR.

近年来,阿尔茨海默病(Alzheimer's disease, AD)血液生物标志物的研究备受关注。在临床研究中,反复的冷冻/解冻循环经常发生,并可能影响生物标志物的稳定性。本研究旨在研究血浆中淀粉样蛋白-β 1-40 (Aβ1-40)、淀粉样蛋白-β 1-42 (Aβ1-42)和总tau蛋白(T-tau)在冻融循环中的稳定性。方法:按标准化程序收集健康对照(n = 2)、AD患者(n =3)和帕金森病患者(n =3)的血浆样本,并立即在-80°C冷冻。样品经过5次冷冻/解冻(-80°C/室温)循环。采用免疫磁还原(IMR)法监测冻融试验期间Aβ1-40、Aβ1-42和T-tau蛋白的浓度。计算每个生物标志物在每次冷冻/解冻循环后的相对浓度百分比。结果:通过冻融循环,Aβ1-40、Aβ1-42和T-tau的平均相对百分比呈下降趋势,分别为100 ~ 97.11%、100 ~ 94.99%和100 ~ 95.65%。然而,降幅不到6%。对于所有三种生物标志物,新鲜血浆水平与经历5次冷冻/解冻循环的血浆水平之间无统计学意义(p > 0.1)。结论:血浆a - β1-40、a - β1-42和T-tau蛋白在IMR检测的5个冻融循环中保持稳定。
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引用次数: 13
Evaluation of Postoperative Delirium: Validity and Reliability of the Nursing Delirium Screening Scale in the Turkish Language. 术后谵妄的评价:土耳其语护理谵妄筛查量表的效度和信度。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-12-05 eCollection Date: 2019-09-01 DOI: 10.1159/000501903
Fadime Çınar, Fatma Eti Aslan

Purpose: Postoperative delirium is the most well-known form of postoperative cognitive impairment in all patient groups, especially in the elderly. Delirium is a syndrome that causes serious consequences, increasing mortality and morbidity rates and extending the length of hospital stay. The aim of this study was to evaluate the validity and reliability of the Turkish version of the Nursing Delirium Screening Scale (Nu-DESC).

Method: One hundred twelve patients who were hospitalized for a surgical operation in the orthopedics, neurosurgery, and general surgery clinic of a state hospital for 3 months were evaluated concurrently (and independently for delirium). Patients were observed by clinical nurses 3 times over a 24-h period. The presence of delirium was diagnosed by 2 neurologists according to DSM-IV criteria. Student's t test, the χ2 test, and the Mann-Whitney U test were used, and construct validity, intrascale factor analysis, interrater reliability, and specificity and sensitivity (ROC) analyses were performed for descriptive analysis. SPSS 25.0 and MedCalc18.6 were used for statistical analysis.

Results: Delirium was detected in 28 patients according to the Nu-DESC. The ICC (intraclass correlation) is 0.97 in the 95% confidence interval from 0.96 to 0.98 for agreement between nurses and neurologists for the total Nu-DESC score. Weighted κ rates were between 0.78 and 0.92. In the ROC analysis of the Nu-DESC scale, the optimum cutoff value calculated for the 1,344 observations and 112 patients was determined as >1 according to the maximum sensitivity and the specific situation. Sensitivity at the cut-off point was 92.27; specificity was determined as 92.72. The Youden index was found to be J = 0.845 (0 < J = 0.845 < 1).

Conclusion: We believe that Turkish translation of Nu-DESC is valid and reliable for clinicians, nurses, and researchers and will contribute to delirium studies.

目的:术后谵妄是所有患者群体中最常见的术后认知障碍形式,尤其是在老年人中。谵妄是一种导致严重后果的综合征,会增加死亡率和发病率,延长住院时间。本研究的目的是评估土耳其版护理谵妄筛查量表(Nu-DESC)的效度和信度。方法:对在某公立医院骨科、神经外科、普外科门诊住院3个月的外科手术患者112例进行并发评估(谵妄独立评估)。临床护士24小时内对患者进行3次观察。谵妄的存在由2名神经科医生根据DSM-IV标准诊断。采用学生t检验、χ2检验和Mann-Whitney U检验,描述性分析采用结构效度、尺度内因子分析、间信度和特异性和敏感性(ROC)分析。采用SPSS 25.0和MedCalc18.6进行统计学分析。结果:根据Nu-DESC,有28例患者出现谵妄。护士和神经科医生对Nu-DESC总分的一致性在0.96 ~ 0.98的95%置信区间内,ICC(类内相关性)为0.97。加权κ率在0.78 ~ 0.92之间。在Nu-DESC量表的ROC分析中,根据最大灵敏度和具体情况,确定1344例观察和112例患者计算的最佳截断值为>1。截断点灵敏度为92.27;特异性为92.72。约登指数为J = 0.845 (0 < J = 0.845 < 1)。结论:我们认为Nu-DESC的土耳其语翻译对临床医生、护士和研究人员来说是有效和可靠的,并将有助于谵妄的研究。
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引用次数: 11
Nursing Staff's Knowledge and Attitudes toward Dementia: A Pilot Study from an Indian Perspective 护理人员对痴呆症的知识和态度:一项来自印度视角的初步研究
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-10-01 DOI: 10.1159/000502770
B. S. Strøm, K. Engedal, Lasse Andreassen
Background: Despite the increased prevalence of dementia in India, reports indicate little awareness of the disease. Symptoms are often misinterpreted or neglected, which could lead to late diagnosis, reducing the choices available regarding future care. Considering that most nurses caring for the elderly will work with people with dementia in the future, there is concern surrounding their ability to meet the needs of these patients, requiring them to obtain the necessary knowledge and positive attitudes for treatment. Aims: To describe the knowledge of and attitudes toward dementia among nursing staff working in residential care facilities for elderly populations in India. Methods: A cross-sectional survey was conducted in 3 nursing homes in India in which 15 nursing staff conducted self-assessments of their knowledge and attitudes toward dementia using the Alzheimer’s Disease Knowledge Scale (ADKS) and the Attitude toward Alzheimer’s Disease and Related Dementias Scale (DAS) for each respective assessment. Descriptive statistics were used to describe staffs’ attitudes and knowledge concerning dementia. Continuous variables were presented as means ± SD, while the categorical variables were presented as percentages. Results: Although the majority of the participants answered that Alzheimer’s disease cannot be cured, about half reported that people with dementia, in rare cases, can recover from the disease. While all participants agreed that people with dementia can feel when others are kind to them, almost half disagreed that people living with dementia can enjoy life. Conclusion: These findings reveal that nursing staff have limited knowledge of dementia, but their attitudes toward people living with dementia tend to be positive.
背景:尽管痴呆症在印度的患病率增加,但报告显示人们对这种疾病的认识很少。症状往往被误解或忽视,这可能导致诊断迟缓,减少了未来护理的选择。考虑到大多数护理老年人的护士未来将与痴呆症患者一起工作,人们担心他们是否能够满足这些患者的需求,要求他们获得必要的知识和积极的治疗态度。目的:描述在印度老年人居住护理机构工作的护理人员对痴呆症的知识和态度。方法:采用横断面调查方法,对印度3家养老院进行调查,其中15名护理人员分别使用阿尔茨海默病知识量表(ADKS)和阿尔茨海默病及相关痴呆态度量表(DAS)对其痴呆知识和态度进行自我评估。使用描述性统计描述员工对痴呆症的态度和知识。连续变量以均数±SD表示,分类变量以百分比表示。结果:虽然大多数参与者回答说阿尔茨海默病无法治愈,但大约一半的人报告说,在极少数情况下,痴呆症患者可以从疾病中恢复过来。虽然所有的参与者都同意,当别人对他们友好时,痴呆症患者会有感觉,但几乎一半的人不同意痴呆症患者可以享受生活。结论:这些发现表明护理人员对痴呆症的认识有限,但对痴呆症患者的态度趋于积极。
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引用次数: 19
Effects of Cognitive Performance and Affective Status on Fatigue in Parkinson's Disease 认知表现和情感状态对帕金森病患者疲劳的影响
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-09-24 DOI: 10.1159/000498883
Susan Spirgi, A. Meyer, P. Calabrese, U. Gschwandtner, P. Fuhr
Background: Fatigue is a common non-motor symptom in Parkinson’s disease (PD) and is typically assessed via self-reported questionnaires such as the Parkinson’s Fatigue Scale (PFS). The PFS captures the presence of subjective experience of physical fatigue as well as its impact on daily functioning. Objectives: We aimed to investigate whether different variables (cognition, neuropsychiatric symptoms, disease-related measures) are associated with the experience of physical fatigue in comparison to fatigue affecting daily functioning. Method: Sixty-two non-demented PD patients were evaluated through questionnaires assessing fatigue, daytime sleepiness, apathy, depression, anxiety, and cognition. Items of fatigue were classified and summarized into two index variables measuring either the subjective experience of physical fatigue or the impact of fatigue on daily functioning. Linear regression with a stepwise elimination procedure was conducted to select the significant predictors for each index variable separately. Results: Subjective experience of physical fatigue (Model 1; r2 = 0.46; p <0.01) was significantly associated with higher levels of depression (b =0.07; p <0.01), anxiety (b =0.03; p <0.05), and lower performances in verbal episodic memory (b =–0.16; p <0.05). Fatigue affecting daily functioning (Model 2; r2 = 0.44; p <0.05) was significantly related to higher levels of depression (b = 0.07; p < 0.01), anxiety (b = 0.03; p > 0.05), and lower motor functioning (b = 0.01; p = 0.05). Conclusions: In conclusion, our work supports associations between fatigue and other neuropsychiatric symptoms in PD and extends prior work suggesting that motor disturbances are specifically linked to fatigue-related impairment of daily functioning, but not to the subjective experience of physical fatigue.
背景:疲劳是帕金森病(PD)常见的非运动症状,通常通过帕金森疲劳量表(PFS)等自我报告问卷进行评估。PFS捕捉到身体疲劳的主观体验以及它对日常功能的影响。目的:我们的目的是研究不同的变量(认知、神经精神症状、疾病相关措施)是否与身体疲劳体验相关,而不是疲劳影响日常功能。方法:采用疲劳、日间嗜睡、冷漠、抑郁、焦虑、认知等问卷对62例非痴呆性PD患者进行评估。疲劳项目被分类并归纳为两个指标变量,测量身体疲劳的主观体验或疲劳对日常功能的影响。采用逐步消除法进行线性回归,分别选取各指标变量的显著性预测因子。结果:身体疲劳的主观体验(模型1;R2 = 0.46;P 0.05),运动功能下降(b = 0.01;P = 0.05)。结论:总之,我们的工作支持疲劳和PD中其他神经精神症状之间的联系,并扩展了先前的工作,表明运动障碍与疲劳相关的日常功能损害有关,但与身体疲劳的主观体验无关。
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引用次数: 7
Polypharmacy Associated with Cognitive Decline in Newly Diagnosed Parkinson's Disease: A Cross-Sectional Study. 新诊断帕金森病患者认知能力下降的多药治疗:一项横断面研究。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2019-09-10 eCollection Date: 2019-09-01 DOI: 10.1159/000502351
Nobuyuki Ishii, Hitoshi Mochizuki, Katsuya Sakai, Go Ogawa, Kazutaka Shiomi, Masamitsu Nakazato

Aims: Polypharmacy is well known to affect cognitive function in community-dwelling older adults. However, the effect of polypharmacy on cognitive function in patients with newly diagnosed Parkinson's disease remains unknown. Here, we evaluated the association between polypharmacy and cognitive function in patients with newly diagnosed Parkinson's disease.

Methods: This cross-sectional study enrolled 131 consecutive hospitalized patients with newly diagnosed Parkinson's disease. Cognitive function was evaluated with the Mini-Mental State Examination and analyzed between groups of patients with or without polypharmacy. Comparisons were adjusted for confounders by performing inverse probability weighting with propensity scores.

Results: After inverse probability weighting, patients in the polypharmacy group had a significantly lower Mini-Mental State Examination score than patients in the nonpolypharmacy group (26.2 vs. 27.7, p = 0.001).

Conclusion: Polypharmacy was associated with cognitive decline in patients with newly diagnosed Parkinson's disease. This finding suggests that medication reduction might serve as a promising intervention to prevent the development of dementia in patients with early Parkinson's disease. Further prospective studies are needed to determine whether medication reduction improves cognitive function in patients with newly diagnosed Parkinson's disease.

目的:众所周知,多药治疗会影响社区老年人的认知功能。然而,多药治疗对新诊断的帕金森病患者认知功能的影响仍然未知。在这里,我们评估了新诊断的帕金森病患者的多药治疗与认知功能之间的关系。方法:这项横断面研究纳入了131名连续住院的新诊断帕金森病患者。认知功能通过迷你精神状态检查进行评估,并在使用或不使用多种药物的患者组之间进行分析。通过对倾向得分进行反向概率加权,对混杂因素进行比较调整。结果:经过逆概率加权后,多药治疗组的患者的迷你精神状态检查得分显著低于非多药组(26.2比27.7,p=0.001)。结论:多药治疗与新诊断的帕金森病患者的认知能力下降有关。这一发现表明,减少药物治疗可能是一种很有前途的干预措施,可以预防早期帕金森病患者患痴呆症。需要进一步的前瞻性研究来确定减少药物治疗是否能改善新诊断的帕金森病患者的认知功能。
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引用次数: 12
期刊
Dementia and Geriatric Cognitive Disorders Extra
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