scholarly journals Is there evidence behind pre- or perioperative cognitive training in gynaecological patients on the prevention of perioperative cognitive dysfunction? A review

2021 ◽  
Author(s):  
Sophia Volz ◽  
Franziska Koch ◽  
Davud Dayan ◽  
Miriam Upadhyay ◽  
Stephanie Otto ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Cognitive Training ◽  
Enhanced Recovery ◽  
Current Knowledge ◽  
Age Groups ◽  
Relaxation Methods ◽  
Personal Training ◽  
Search Terms ◽  
Patients At Risk

Abstract Purpose Perioperative cognitive dysfunction can be observed in all age groups of patients. Sometimes, this is more stressful to the patient than the actual surgical wound. Enhanced recovery after surgery pathways screen for patients at risk and lead to early post-surgical intervention. To prevent cognitive dysfunction, a prehabilitation approach might be useful. Methods This systematic literature review provides an overview on the current knowledge on prehabilitation for cognitive dysfunction for gynaecological patients by searching the National Library of Medicine (PubMed) in February 2020 to identify publications regarding presurgical cognitive training with three different search terms. Results 501 articles were identified and after screening for eligibility five were left for further analysis. Generally, cognitive function is split into several cognitive aspects like anxiety or memory, speed, attention, flexibility or problem-solving functions. Each of these aspects can/need to be trained to show an improvement after general anaesthesia. Training possibilities range from relaxation methods via music, one-on-one personal training sessions to electronically supported training units. Conclusion Prehabilitation of the cognitive function can be split in different cognitive domains. Each of these domains seem to be influenced by training. The training itself can be based on applications or known relaxation methods or even old-fashioned board games. The evidence is, however, still low and there is a need for further studies.

Association of Micro RNA and Postoperative Cognitive Dysfunction: A Review

2020 ◽  
Vol 20 (17) ◽  
pp. 1781-1790
Author(s):  
Noor Anisah Abu Yazit ◽  
Norsham Juliana ◽  
Srijit Das ◽  
Nur Islami Mohd Fahmi Teng ◽  
Nadia Mohd Fahmy ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Chromosomal Abnormalities ◽  
Current Knowledge ◽  
System Development ◽  
Genetic Disorder ◽  
Postoperative Cognitive Dysfunction ◽  
Clinical Importance ◽  
Nervous System Development ◽  
Micro Rna ◽  
A Genome

Postoperative Cognitive Dysfunction (POCD) refers to the condition of neurocognitive decline following surgery in a cognitive and sensory manner. There are several risk factors, which may be life-threatening for this condition. Neuropsychological assessment of this condition is very important. In the present review, we discuss the association of apolipoprotein epsilon 4 (APOE ε4) and few miRNAs with POCD, and highlight the clinical importance for prognosis, diagnosis and treatment of POCD. Microarray is a genome analysis that can be used to determine DNA abnormalities. This current technique is rapid, efficient and high-throughout. Microarray techniques are widely used to diagnose diseases, particularly in genetic disorder, chromosomal abnormalities, mutations, infectious diseases and disease-relevant biomarkers. MicroRNAs (miRNAs) are a class of non-coding RNAs that are widely found distributed in eukaryotes. Few miRNAs influence the nervous system development, and nerve damage repair. Microarray approach can be utilized to understand the miRNAs involved and their pathways in POCD development, unleashing their potential to be considered as a diagnostic marker for POCD. This paper summarizes and identifies the studies that use microarray based approaches for POCD analysis. Since the application of microarray in POCD is expanding, there is a need to review the current knowledge of this approach.

Arterial Stiffness, Cognitive Dysfunction and Adherence to Antihypertensive Agents. Is there a Link to Hypertensive Patients?

2020 ◽  
Vol 18 (4) ◽  
pp. 410-417 ◽  
Author(s):  
Rigas G. Kalaitzidis ◽  
Thalia Panagiotopoulou ◽  
Dimitrios Stagikas ◽  
Kosmas Pappas ◽  
Olga Balafa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Arterial Stiffness ◽  
Cognitive Dysfunction ◽  
Antihypertensive Drugs ◽  
Patient Adherence ◽  
Antihypertensive Agents ◽  
Treatment Compliance ◽  
Poor Adherence ◽  
Large Artery ◽  
Adherence To Medication

:The incidence of hypertension (HTN) and its cardiovascular (CV) complications are increasing throughout the world. Blood pressure (BP) control remains unsatisfactory worldwide. Medical inertia and poor adherence to treatment are among the factors that can partially explain, why BP control rate remains low. The introduction of a method for measuring the degree of adherence to a given medication is now a prerequisite. Complex treatment regimes, inadequate tolerance and frequent replacements of pharmaceutical formulations are the most common causes of poor adherence. In contrast, the use of stable combinations of antihypertensive drugs leads to improved patient adherence.:We aim to review the relationships between arterial stiffness, cognitive function and adherence to medication in patients with HTN.:Large artery stiffening can lead to HTN. In turn, arterial stiffness induced by HTN is associated with an increased CV and stroke risk. In addition, HTN can induce disorders of brain microcirculation resulting in cognitive dysfunction. Interestingly, memory cognitive dysfunction leads to a reduced adherence to drug treatment. Compliance with antihypertensive treatment improves BP control and arterial stiffness indices. Early treatment of arterial stiffness is strongly recommended for enhanced cognitive function and increased adherence.

scholarly journals Protocol for a systematic review on the experience of informal caregivers for people with a moderate to advanced dementia within a domestic home setting

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Charles James ◽  
Catherine Walshe ◽  
Katherine Froggatt
Keyword(s):  
Systematic Review ◽  
Negative Impact ◽  
Current Knowledge ◽  
Informal Caregivers ◽  
Informal Caregiving ◽  
Bibliographic Databases ◽  
Future Research ◽  
Advanced Dementia ◽  
Home Setting ◽  
Search Terms

Abstract Background The knowledge about the experience of informal caregivers who provide care to people with moderate to advanced dementia in a domestic home setting is limited. A consequence of long hours of caregiving in addition to dealing with normal challenges of daily living is their experience of a poor quality of life. Some of their experiences may be described in terms of a feeling of powerlessness to make changes during care provision. This feeling may also suggest an experience of moral distress. The aim of this systematic review is to synthesise qualitative evidence relating to these experiences. Methods This review adopts a narrative synthesis approach. A search will be conducted for studies written in the English language in the bibliographic databases MEDLINE Complete, CINAHL, EMBASE, PsycINFO, Web of Science and Academic Search Complete covering periods from 1984 to present. Included studies will be qualitative or mixed-methods designs. The search terms will be related to dementia and caregivers, and the process will be focused on dementia at the moderate to the advanced stages within the domestic home setting. Reference lists of included papers will also be searched for additional relevant citations. Search terms and strategies will be checked by two independent reviewers. The identification of abstracts and full texts of studies will be done by the author, while the quality and the risk of bias will also be checked by the two independent reviewers. Discussion Psychological distress is cited as an experience reported within informal caregiving. For the caregiver, it is associated with a negative impact on general health. To date, no synthesis exists on the specific experience of informal caregiving for people with moderate to advanced dementia within the domestic home setting. This review considers that variation of accounts contributes to how the informal caregivers’ general experience is explored in future research. This may enable gaps in current knowledge to be highlighted within the wider context of caregiving in the domestic home setting. Systematic review registration This review is registered with PROSPERO (CRD42020183649).

scholarly journals SAT0623-HPR THE LIVED EXPERIENCES OF COGNITIVE DYSFUNCTION IN ADULTS WITH FIBROMYALGIA: A QUALITATIVE SYSTEMATIC REVIEW

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1271.1-1272
Author(s):  
S. Derham ◽  
J. Lewis ◽  
E. Dures ◽  
F. Cramp
Keyword(s):  
Clinical Practice ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Lived Experiences ◽  
Critical Appraisal ◽  
Negative Impact ◽  
Practice Research ◽  
Future Research ◽  
Poor Sleep ◽  
Cognitive Changes

Background:Adults with fibromyalgia frequently report symptoms of cognitive dysfunction, often referred to as fibrofog. However primary research exploring cognitive dysfunction in the lives of adults with fibromyalgia is very limited (Kravitz and Katz, 2015).Objectives:The aim of this review was to (i) synthesise the qualitative literature on the lived experiences of cognitive dysfunction in adults with fibromyalgia, (ii) develop common themes through thematic analysis and (iii) identify knowledge gaps to inform future research and clinical practice in this area.Methods:Seven electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Amed, Scopus and OpenGrey), reference lists of key articles and two high impact qualitative journals were searched from 1990 to November 2018. Articles were eligible for inclusion if they reported primary qualitative data exploring the experiences of cognitive dysfunction in adults with fibromyalgia. Included studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist and extracted data analysed using narrative synthesis. SD conducted critical appraisal and data extraction on all included studies. FC, JL and ED reviewed five papers each. All papers were reviewed by two co-authors. Of the 1413 records identified, 15 studies were selected for inclusion.Results:These studies included 208 women and 22 men with fibromyalgia, aged 18 to 72 years and representing seven different countries. Duration of diagnosis was four months to 34 years. Fourteen studies used interviews and one used focus groups. None of the included studies focussed exclusively on cognitive function in adults with fibromyalgia. Three studies identified themes specific to cognitive dysfunction and fibromyalgia symptoms. The remaining 12 studies presented relevant data intertwined with the overall lived experiences of fibromyalgia.Cognitive dysfunction, as a part of fibromyalgia, was often unpredictable. Problems with memory and concentration that were most commonly reported were emotionally distressing and affected functional and vocational activities. Participants found communication effortful, with a negative impact on work, leisure and social activities. Stress, fear and worry around perceived cognitive changes were commonly expressed. Lost employment or changed work roles and relationships, due to cognitive difficulties, had negative impacts for many participants. The terms cognitive dysfunction and fibrofog were used interchangeably within the studies, but lacked common definition. This introduced uncertainty around whether participants and authors were describing the same phenomenon.Conclusion:Adults with fibromyalgia experience unpredictable and emotionally impactful difficulties related to cognitive dysfunction. Functional impact was broad-reaching, particularly around work ability and lost employment opportunities. It is unclear how cognitive symptoms in fibromyalgia related to co-morbid symptoms such as pain, fatigue and poor sleep. Further research focusing on the full impact of cognitive function on the lives of adults with fibromyalgia is recommended to inform clinical practice. Research to establish clarity of definition of the terms cognitive dysfunction and fibrofog within fibromyalgia is highly recommended.References:[1]Kravitz H, Katz R. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice. Rheumatology International. 2015;35(7):1115-25.Acknowledgments:This work is supported by the National Institute for Heath Research [ICA-PCAF-2018-01-078 to SD]Disclosure of Interests:Sandra Derham: None declared, Jenny Lewis: None declared, Emma Dures Grant/research support from: Independent Learning Grant from Pfizer, combined funding for a research fellow from Celgene, Abbvie and Novartis, Paid instructor for: A fee from Novartis to deliver training to nurses., Fiona Cramp: None declared

scholarly journals New Perspectives in Stroke Management: Old Issues and New Pathways

2021 ◽  
Vol 11 (6) ◽  
pp. 767
Author(s):  
Fabio Pilato ◽  
Rosalinda Calandrelli ◽  
Fioravante Capone ◽  
Michele Alessiani ◽  
Mario Ferrante ◽  
...  
Keyword(s):  
Time Window ◽  
Enhanced Recovery ◽  
Current Knowledge ◽  
Oral Anticoagulants ◽  
Chronic Phase ◽  
Stroke Care ◽  
New Drugs ◽  
Stroke Patients ◽  
Social Burden ◽  
Novel Approaches

Stroke is a leading cause of disability and death worldwide and social burden is huge in terms of disabilities, mortality and healthcare costs. Recently, in an acute stroke setting, renewed interest in disease-modifying therapies and novel approaches has led to enhanced recovery and the reduction of long-term disabilities of patients who suffered a stroke. In the last few years, the basic principle “time is brain” was overcome and better results came through the implementation of novel neuroimaging tools in acute clinical practice, allowing one to extend acute treatments to patients who were previously excluded on the basis of only a temporal selection. Recent studies about thrombectomy have allowed the time window to be extended up to 24 h after symptoms onset using advanced neuroradiological tools, such as computer tomography perfusion (CTP) and magnetic resonance imaging (MRI) to select stroke patients. Moreover, a more effective acute management of stroke patients in dedicated wards (stroke units) and the use of new drugs for stroke prevention, such as novel oral anticoagulants (NOACs) for atrial fibrillation, have allowed for significant clinical improvements. In this editorial paper, we summarize the current knowledge about the main stroke-related advances and perspectives and their relevance in stroke care, highlighting recent developments in the definition, management, treatment, and prevention of acute and chronic complications of stroke. Then, we present some papers published in the Special Issue “Clinical Research on Ischemic Stroke: Novel Approaches in Acute and Chronic Phase”.

scholarly journals Effects of physical activity on cognitive function among patients with diabetes in China: a nationally longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anying Bai ◽  
Liyuan Tao ◽  
Jia Huang ◽  
Jing Tao ◽  
Jue Liu
Keyword(s):  
Physical Activity ◽  
Executive Function ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Age Groups ◽  
Screening Tools ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Lagged Dependent Variable

Abstract Background We aimed to examine the effect of physical activity on different cognitive domains among patients with diabetes. Methods We used two waves of data from the Chinese Health and Retirement Longitudinal Study (CHARLS, 2013–2015), a nationally representative dataset of Chinese population aged over 45. Total physical activity scores were calculated based on the International Physical Activity Questionnaire (IPAQ). Executive function and episodic memory were used as measures of cognitive function. We conducted lagged dependent variable models to explore the association between physical activity and cognitive function in full sample as well as two different age groups (45–65, ≥65). Results: 862 diabetic patients were included. We found that diabetic participants who had greater level of physical activity at baseline were associated with better episodic memory function in 2 years (p < 0.05). Moreover, physical activity was significantly associated with less decline in episodic memory in fully adjusted models, and the associations were stronger among patients aged 45–65 years (p < 0.05). No statistically significant association was found between physical activity and executive function in all age groups. Conclusions Physical activity may prevent some of the potential decline in episodic memory in diabetic patients. Clinicians and public health departments should strengthen the promotion of physical activity and develop early screening tools among diabetic participants to prevent the progression of cognitive impairment.

scholarly journals 405 - Music Therapy in the management of dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 121-121
Author(s):  
Catarina Pedro ◽  
Beatriz Jorge ◽  
Mariana Duarte
Keyword(s):  
Cognitive Function ◽  
Music Therapy ◽  
Behavioral Problems ◽  
Positive Impact ◽  
Current Knowledge ◽  
Neuropsychiatric Symptoms ◽  
World Health ◽  
Psychotic Symptoms ◽  
The World ◽  
Health Organization

Introduction:Dementia has become a worldwide concern. According to the World Health Organization, there are 50 million individuals suffering from dementia across the world and approximately 20 million new cases are diagnosed each year. The efficacy of medications in controlling agitation and psychotic symptoms is modest and may cause serious adverse effects, outlining the urge for new treatment methods for patients with dementia. Music therapy (MT) is a nonpharmacologic strategy that is used in patients with early-to-late stages of dementia with promising results.Objectives:The aim of this presentation is to evaluate the benefits of music therapy in cognitive functioning and neuropsychiatric symptoms in patients diagnosed with dementia. We also summarize the current knowledge about this topic.Methods:A non-systematic review of the literature was performed on PubMed, PsycINFO and Web of science using selected keywords.Results:MT sustains its benefit because musical memory regions in the brain are relatively spared compared to cognitive function. “Musical memories” can, thus, be stored longer than non-musical memories, allowing to recall associated life events and emotions. Systematic reviews suggest that MT seem to have a positive effect on symptoms such as depression, anxiety and behavioral problems while the findings concerning agitation/aggression are inconsistent. No large differences were found between studies using live or recorded music although the latter reported more of a consistently positive impact on behavioral and psychological outcomes. The studies using live music, however, reported specific benefits to relationships and interactions.Conclusions:The majority of the studies have methodological limitations, making it difficult to offer firm conclusions. Despite this, there were positive results on aspects of quality of life, cognitive function, behavioral, psychological, physiological and communication outcomes.

scholarly journals Study of cognitive functions in major idiopathic interstitial pneumonias

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohamed W. Zakaria ◽  
Reem I. El-Korashy ◽  
Mostafa O. Shaheen ◽  
Samah Selim ◽  
Kwashi J. Amum
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Control Group ◽  
Healthy Individuals ◽  
Co Morbidity ◽  
Impaired Lung Function ◽  
State Examination

Abstract Background Cognitive dysfunction in idiopathic interstitial pneumonia (IIP) is an important clinical co-morbidity that is associated with impaired lung function. The aim of the work is to assess cognitive function in major IIP and to find out the relation between cognitive dysfunction and the oxygenation parameters. Results Fifty individuals were involved in the study; 30 patients with major IIP and 20 healthy individuals. Patients with IIP had significantly lower mini mental state examination (MMSE) score compared to the control group (P < 0.001). Wechsler Deterioration Index (WDI) revealed that 33.3% (n = 10) of the patients with IIP had sure cognitive impairment and 26.6% (n = 8) had ongoing cognitive deterioration. Patients with idiopathic pulmonary fibrosis (IPF) had lower cognitive function than other IIP. Conclusion There is an impairment of cognitive function in patients with major IIP, particularly in IPF, as measured by WDI and MMSE. Further large studies are needed to assess the possible predictors of cognitive impairment and their effects on the patients’ outcome.

Relationship among anesthesia technique, surgical stress, and cognitive dysfunction following spinal surgery: a randomized trial

2019 ◽  
Vol 31 (6) ◽  
pp. 894-901 ◽  
Author(s):  
Anna A. Ezhevskaya ◽  
Alexei M. Ovechkin ◽  
Zhanna B. Prusakova ◽  
Valery I. Zagrekov ◽  
Sergey G. Mlyavykh ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Pain Management ◽  
Epidural Analgesia ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Group 2 ◽  
Cellular Immune ◽  
Inflammatory Changes ◽  
Group 1

OBJECTIVESurgical trauma is known to result in systemic inflammatory changes that can lead to postoperative cognitive dysfunction. In the present study, the authors compared the effects of an epidural anesthesia protocol to those of traditional anesthesia with regard to postoperative inflammatory changes, cellular immunity, and cognitive dysfunction.METHODSForty-eight patients, ages 45–60 years, underwent multilevel thoracolumbar decompression and fusion and were randomly assigned to one of two groups: group 1 (27 patients) had combined epidural and general anesthesia, followed by epidural analgesia for 48 hours after surgery, and group 2 (21 patients) had general anesthesia, followed by traditional opioid pain management after surgery. At multiple time points, data on pain control, cognitive function, cellular immunity, and inflammatory markers were collected.RESULTSGroup 1 patients demonstrated lower pain levels, less systemic inflammation, less cellular immune dysfunction, and less postoperative cognitive dysfunction than group 2 patients.CONCLUSIONSThe use of combined epidural and general anesthesia followed by postoperative epidural analgesia during the first 48 hours after multilevel thoracolumbar decompression and fusion surgery had a significant positive effect on pain management, cellular immune function, systemic inflammation, and postoperative cognitive function.Clinical trial registration no.: 115080510080 (http://rosrid.ru)

scholarly journals Does postoperative cognitive decline after coronary bypass affect quality of life?

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001569
Author(s):  
Fredrike Blokzijl ◽  
Frederik Keus ◽  
Saskia Houterman ◽  
Willem Dieperink ◽  
Iwan C C van der Horst ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Cognitive Test ◽  
Physical Component Score ◽  
Cognitive Changes ◽  
Component Score ◽  
Postoperative Cognitive Decline

ObjectiveThis study aimed to explore the influence of coronary artery bypass grafting (CABG) on both postoperative cognitive dysfunction and quality of life (QoL) and the association between the two patient-related outcomes.MethodsIn a prospective, observational cohort study, patients with elective, isolated CABG were included. Cognitive function was assessed using the Cogstate computerised cognitive test battery preoperatively, 3 days and 6 months after surgery. QoL was measured preoperatively and at 6 months using the RAND-36 questionnaire including the Physical Component Score (PCS) and the Mental Component Score (MCS). Regression analysis, with adjustment for confounders, was used to evaluate the association between postoperative cognitive dysfunction and QoL.ResultsA total of 142 patients were included in the study. Evidence of persistent cognitive dysfunction was observed in 33% of patients after 6 months. At 6 months, the PCS had improved in 59% and decreased in 21% of patients, and the MCS increased in 49% and decreased in 29%. Postoperative cognitive changes were not associated with QoL scores.ConclusionsPostoperative cognitive dysfunction and decreased QoL are common 6 months after surgery, although cognitive function and QoL were found to have improved in many patients at 6 months of follow-up. Impaired cognitive function is not associated with impaired QoL at 6 months.Trial registration numberNCT03774342.

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