Dementia and neurocognitive disorders最新文献

Background and purpose: Neural stem cells (NSCs) have the ability to regenerate, proliferate, and differentiate, enabling them to play important roles in the recovery of the damaged nervous system. However, in neurodegenerative diseases such as Alzheimer's disease (AD), the NSCs are damaged as well. Glia-like cells from human mesenchymal stem cells (ghMSCs) are functionally enhanced adult stem cells. In the present study, we investigated whether ghMSCs could protect NSCs from amyloid beta (Aβ)-mediated toxicity.

Methods: Rat NSCs were obtained from E13-14 fetal rat cortices. NSCs were seeded in pre-coated plates, and the next day, cells were simultaneously treated with 20 μM Aβ and 0.4 μm pore insert well-seeded ghMSCs. After 48 hours of co-treatment, cell viability and proliferation were evaluated. After 2 hours of co-treatment, western blotting was performed to measure inflammasome-related factors, such as NOD-like receptor family pyrin domain containing 3, caspase-1, and interleukin-1β.

Results: The results showed that ghMSCs increased viability and proliferation and reduced the toxicity of NSCs injured by Aβ by reducing the NRLP3 inflammasome activation of NSCs induced by Aβ.

Conclusions: In this study, we confirmed that ghMSCs could protect NSCs in an in vitro model of AD through the regulation of inflammatory response.

Background and purpose: To identify biomarkers for prediction of the progression to dementia in mild cognitive impairment (MCI) patients, evaluation of brain structure changes has been validated by a comprehensive visual grading scale (CVRS) through magnetic resonance imaging (MRI). In this study, we specifically elucidated for the cognitive change of MCI patients classified based on AT(N) pathological status classification during the follow-up period of 3 years through the CVRS.

Methods: The 301 patients with initial MCI visited at least once for follow-up period. The data used in this study were obtained from the Alzheimer's disease (AD) Neuroimaging Initiative study. Brain atrophy was assessed by CVRS using MRI. AT(N) profiles were classified by cerebrospinal fluid abnormality. Based on the AT(N) assessment, all individuals in this study were divided into 3 groups (normal state biomarker, suspected non-Alzheimer's pathology [SNAP], or Alzheimer's continuum). The cox regression was used to analyze the hazard ratios of CVRS for progression to dementia.

Results: Sixty-three progressed and 238 remained stable to dementia and the CVRS (mean±standard deviation) had significant difference between progressive MCI and stable MCI (p<0.001). Univariate and multivariate cox regression results (p<0.001) showed the independence of initial CVRS as a predictor for the progression to dementia. Moreover, comparing the classified AT(N) pathology group, SNAP and AD, effectiveness of CVRS as a predictor was verified only in Alzheimer's continuum.

Conclusions: The initial CVRS score as a predictor of dementia progression was independently validated at the stage of Alzheimer's progression among AT(N) pathologically differentiated MCI.

Background and purpose: Appropriate medication treatment could enable both cognitively impaired patients and caregivers to hold on their cognitive functioning and quality of life. Thus, medication management and the factors influencing how management for this condition is carried out must be identified. In this study we aimed to evaluate the frequency of medication nonadherence (MNA) or drug overuse for cognitive impairment (DOC) and to extract significant variables, including the demographic and social characteristics, vascular risk factors, and cognitive status, for the diagnosis of MNA and DOC in Korean patients.

Methods: We investigated patients aged over 50 years between March 2019 and June 2019 via the cognitive enHancement of patIents with acQuired cognitive impairment (HIQ) campaign. MNA was defined as a participant who was classified as having cognitive impairment but did not take any cognition-related drugs, whereas DOC was defined as a participant who had normal cognition but was taking cognition-related drugs.

Results: We included 10,767 patients. The MNA group consisted of 337 participants, whereas the DOC group comprised 1,107 participants. The factors that could differentiate the MNA group from the normal-behavior group were age, education, sex, and the total Korean version of Mini-Mental State Examination (K-MMSE) score. The factors that could differentiate the DOC group from the normal medication-behavior group were age, sex, residential distinction, experience of a dementia screening test, and the total K-MMSE score.

Conclusions: The underlying factors contributing to inadequate dementia-medication management must be understood, and intervention or support is needed to enable safe medication management.

Background and purpose: Rapid population aging and an increase in the demented elderly became major social concerns in South Korea. Environmental design is increasingly recognized as an important aid for long-term care of patients with dementia as well as pharmacotherapy. We did a pilot study to investigate the effect of the Seoul Dementia Healing Design Project In-House Design (S-DHDP-IHD) in improving the quality of life of the cognitively impaired patients and of the S-DHDP Environmental Design (S-DHDP-ED) in increasing daily outdoor activities for cognitively impaired individuals and not cognitively impaired (NCI) elderly residents.

Methods: We applied the S-DHDP-IHD to 2 households of patients with mild cognitive impairment (MCI) and early-stage vascular dementia (VD). We assessed the effectiveness of intervention by surveys and video recordings of daily tasks. Additionally, we applied the S-DHDP-ED to 5 community facilities and randomly selected 287 residents over 65 years old (32 dementia caregivers and 255 NCI elderly) to participate in surveys.

Results: S-DHDP-IHD intervention showed improved instrumental activities in MCI patient and early-stage VD patient. Also, the satisfaction with an intervened home environment was increased. Following S-DHDP-ED intervention, non-demented residents engaged in more outdoor and social activities. They were also satisfied with the function and design of the installed facilities.

Conclusions: S-DHDP encompassing both home and environmental improvements was effective in readapting cognitively impaired individuals and could achieve a customized, holistic approach to dementia caregiving by means of the improved design.

Background and purpose: The Mini Mental State Examination, 2nd edition: Expanded version (MMSE-2: EV) involves an immediate recall (IR) of story memory (SM). A full version of SM has been developed and standardized; it includes delayed recall (DR) and recognition tests in addition to IR to increase its clinical utility as an independent story recall test. This study was conducted to provide norms for the full version of SM in the Korean version of MMSE-2: EV for clinical use.

Methods: A total of 1,168 participants (496 males and 672 females) were included in the study. The ages ranged from 19 to 90 years, and the education level ranged from illiterate to post-graduate. Regression analysis was used to evaluate the relative contributions of demographic variables (age, education, and sex) on the SM measures.

Results: We stratified age into 11 groups, and categorized the education level into 6 groups. It was found that the IR, DR, and recognition scores of SM were affected by age, education level, and sex. We provided corrected means and standard deviations of the IR, DR, and recognition scores of the SM for the demographic variables.

Conclusions: The results indicate the importance of considering demographic variables in interpreting the full version of SM measures. The normative data we have provided in this study should be useful in clinical and research settings for detecting the impairment in verbal memory.

Background and purpose: The effect of the integrated program comprising cognitive training, art therapy, and music therapy has not been extensively studied in patients with Alzheimer's disease (AD). The present study investigated the effect of integrated cognitive intervention therapy on cognition, and activity of daily life (ADL), and mood in patients with mild to moderate AD.

Methods: In this study, the data of 59 patients who met the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer disease and Related Disorders Association (NINCDS-ADRDS) criteria of probable AD among those who registered at the Centenarian's Good Memory Program in Goyang from September 2014 to August 2019 were collected. We statistically analyzed the scores of Korean version of a Mini-Mental Status Examination (K-MMSE), Korean Dementia Screening Questionnaire-Cognition (KDSQ-C), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Seoul-Instrumental Activities of Daily Living (S-IADL) of the same patients before and after the use of integrated cognitive intervention therapy.

Results: K-MMSE slightly increased from 18.7±4.5 to 19.7±5.0 (p<0.001) and KDSQ-C improved from 14.5±7.6 before therapy to 12.6±7.2 after therapy (p=0.001). Mean S-IADL score improved from 17.6±7.6 before therapy to 15.7±9.5 after therapy (p<0.001). Additionally, mean GDS score before the therapy was 5.6±3.5 that improved to 4.2±3.0 after the therapy (p<0.001). Mean BAI score decreased from 8.4±10.3 before therapy to 5.9±8.4 after therapy (p=0.001).

Conclusions: In conclusion, this study demonstrated the possibility that the use of an integrated cognitive therapy improved cognition, ADL, and mood (depression and anxiety) in patients with mild to moderate ADs.

Background and purpose: Four published quantitative systematic reviews showed conflicting results involving coffee consumption and the risk of Alzheimer's disease (AD). The aim of this meta-epidemiological meta-analysis (MEMA) was to evaluate the factors underlying the conflicting results and estimate the effect size and direction of the AD risk associated with coffee consumption in population-based cohort studies.

Methods: The primary subjects of MEMA were derived from 3 cohort studies selected by the related systematic reviews. Additional studies involving the primary subjects were searched using citation discovery tools. Prospective cohort studies evaluating the association between coffee consumption and AD risk were selected. A fixed effects model was applied to estimate the summary relative risk (sRR) and its 95% confidence intervals (CIs). Subgroup analysis was conducted according to the level of coffee consumption. Egger's test was used to evaluate publication bias.

Results: Four cohort studies were finally selected. A total of 36,300 participants from Finland, Sweden, Germany, and the United States of America were selected. The sRR (and its 95% CI) (I-squared value) by highest-versus-lowest method was 0.98 (0.92-1.05) (0.0%). In addition, none of the results of subgroup analyses by the level of coffee consumption showed any statistical significance.

Conclusions: This MEMA found that there was no association between coffee consumption and AD risk. Based on recent evidence suggesting that gene-environment interactions contribute to AD pathogenesis, it is necessary to conduct population-based cohort studies involving non-Caucasians.