The relationship between ventilatory function and cognitive and behavioral impairment in ALS

ObjectiveTo elucidate the relationship between disease stage in amyotrophic lateral sclerosis (ALS), as measured with the King's Clinical Staging System, and cognitive and behavioral change, measured with the Edinburgh Cognitive and Behavioural ALS Screen (ECAS).MethodsA large multicenter observational cohort of 161 cross-sectional patients with ALS and 80 healthy matched controls were recruited across 3 research sites (Dublin, Edinburgh, and London). Participants were administered the ECAS and categorized into independent groups based on their King's clinical disease stage at time of testing.ResultsSignificant differences were observed between patients and controls on all subtests of the ECAS except for visuospatial functioning. A significant cross-sectional effect was observed across disease stages for ALS-specific functions (executive, language, letter fluency) and ECAS total score but not for ALS-nonspecific functions (memory, visuospatial). Rates of ALS-specific impairment and behavioral change were also related to disease stage. The relationship between cognitive function and disease stage may be due to letter fluency impairment, whereas higher rates of all behavioral domains were seen in later King's stage. The presence of bulbar signs, but not site of onset, was significantly related to ALS-specific, ECAS total, and behavioral scores.ConclusionALS-specific cognitive deficits and behavioral impairment are more frequent with more severe disease stage. By end-stage disease, only a small percentage of patients are free of neuropsychological impairment. The presence of bulbar symptoms exaggerates the differences observed between disease stages. These findings suggest that cognitive and behavioral change should be incorporated into ALS diagnostic criteria and should be included in future staging systems.

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Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-020-01903-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Consecutive Series ◽

Sectional Study ◽

Behavioral Impairment ◽

Cross Sectional ◽

Multivariable Logistic Regression ◽

Increased Risk ◽

The Relationship

Abstract Background Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a dementia risk syndrome characterized by later-life emergence of persistent neuropsychiatric symptoms, has yet to be elucidated. We aimed to evaluate the associations between MBI and frailty in older adults without dementia. Methods In this cross-sectional study, a consecutive series of 137 older adults without dementia in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist (MBI-C) at a cut-off point of > 8. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariable logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status. Results At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariable logistic regression analysis demonstrated that compared to those without MBI (MBI- status), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49–37.21, p = 0.02). Frailty and MBI were both significantly associated with both MMSE and MoCA-BC score (p < 0.05). Conclusions Both frailty and MBI status were associated with higher odds of cognitive impairment. MBI was significantly associated with an increased risk of having frailty in the absence of dementia. This association merits further study to identify potential strategies for the early detection, prevention and therapeutic intervention of frailty.

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Mild behavioral impairment is related to frailty in cognitively normal older adults: a cross-sectional study

10.21203/rs.3.rs-34750/v1 ◽

2020 ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Multivariate Logistic Regression ◽

Behavioral Impairment ◽

Cross Sectional ◽

Cognitively Normal ◽

The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in cognitively normal older adults.Methods: This is a cross-sectional study. A consecutive series of 137 cognitively normal older adults in the Anti-Aging study, recruited from primary care clinics, were enrolled. Frailty was estimated using the original Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.6% of the older adults had frailty, 35.0% had prefrailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, p = 0.02). The frailty and MBI categories were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status are related to higher risk of cognitive impairment. MBI is significantly associated with an increased risk of having frailty before overt cognitive impairment. This association merits further study to identify strategies to the early detection, prevention and therapeutic intervention of frailty.

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Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

10.21203/rs.3.rs-34750/v4 ◽

2020 ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Consecutive Series ◽

Sectional Study ◽

Behavioral Impairment ◽

Cross Sectional ◽

Multivariable Logistic Regression ◽

Increased Risk ◽

The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a dementia risk syndrome characterized by later-life emergence of persistent neuropsychiatric symptoms, has yet to be elucidated. We aimed to evaluate the associations between MBI and frailty in older adults without dementia.Methods: In this cross-sectional study, a consecutive series of 137 older adults without dementia in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist (MBI-C) at a cut-off point of >8. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariable logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariable logistic regression analysis demonstrated that compared to those without MBI (MBI- status), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49-37.21, p = 0.02). Frailty and MBI were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status were associated with higher odds of cognitive impairment. MBI was significantly associated with an increased risk of having frailty in the absence of dementia. This association merits further study to identify potential strategies for the early detection, prevention and therapeutic intervention of frailty.

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Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

10.21203/rs.3.rs-34750/v2 ◽

2020 ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Multivariate Logistic Regression ◽

Behavioral Impairment ◽

Cross Sectional ◽

Increased Risk ◽

The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in non-dementia older adults.Methods: This is a cross-sectional study. A consecutive series of 137 non-dementia older adults in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49-37.21, p = 0.02).Conclusions: MBI is significantly associated with an increased risk of having frailty before the presence of overt dementia. This association merits further study to identify strategies for the early detection, prevention and therapeutic intervention of frailty.

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Mild Behavioral Impairment and Subjective Cognitive Decline Predict Cognitive and Functional Decline

Journal of Alzheimer s Disease ◽

10.3233/jad-201184 ◽

2021 ◽

pp. 1-11

Author(s):

Zahinoor Ismail ◽

Alexander McGirr ◽

Sascha Gill ◽

Sophie Hu ◽

Nils D. Forkert ◽

...

Keyword(s):

Cognitive Decline ◽

Early Stage ◽

Functional Decline ◽

Subjective Cognitive Decline ◽

Behavioral Impairment ◽

Dementia Risk ◽

Risk Patients ◽

Additive Risk ◽

Scalable Methods ◽

The Relationship

Background: Mild behavioral impairment (MBI) and subjective cognitive decline (SCD) are dementia risk states, and potentially represent neurobehavioral and neurocognitive manifestations, respectively, of early stage neurodegeneration. Both MBI and SCD predict incident cognitive decline and dementia, are associated with known dementia biomarkers, and are both represented in the NIA-AA research framework for AD in Stage 2 (preclinical disease). Objective: To assess the associations of MBI and SCD, alone and in combination, with incident cognitive and functional decline in a population of older adults. We tested the hypothesis that MBI and SCD confer additive risk for decline. Methods: Cognitively normal participants were followed up annually at Alzheimer’s Disease Centers. Logistic regression assessed the relationship between baseline classification (MBI-SCD-, MBI-SCD+, MBI+SCD-, or MBI+SCD+) and 3-year outcome. Results: Of 2,769 participants (mean age=76), 1,536 were MBI-SCD-, 254 MBI-SCD+, 743 MBI+SCD-, and 236 MBI+SCD+. At 3 years, 349 (12.6%) declined to CDR >0, including 23.1% of the MBI+group, 23.5% of the SCD+group, and 30.9% of the intersection group of both MBI+and SCD+participants. Compared to SCD-MBI-, we observed an ordinal progression in risk (ORs [95% CI]): 3.61 [2.42–5.38] for MBI-SCD+ (16.5% progression), 4.76 [3.57–6.34] for MBI+SCD- (20.7%), and 8.15 [5.71–11.64] for MBI+SCD+(30.9%). Conclusion: MBI and SCD together were associated with the greatest risk of decline. These complementary dementia risk syndromes can be used as simple and scalable methods to identify high-risk patients for workup or for clinical trial enrichment.

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Neuroanatomical Moderators of the Impact of Mild Behavioral Impairment on Cognition

Innovation in Aging ◽

10.1093/geroni/igab046.2626 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 707-707

Author(s):

Hillary Rouse ◽

Brent Small

Keyword(s):

Older Adults ◽

Cortical Thickness ◽

Gray Matter ◽

Gray Matter Volume ◽

Behavioral Impairment ◽

Matter Volume ◽

Cortical Gray Matter ◽

And Performance ◽

The Impact ◽

The Relationship

Abstract Older adults with mild behavioral impairment (MBI), or the presence of late-life neuropsychiatric symptoms, have a unique cognitive phenotype. However, the neural correlates associated with MBI-related cognitive changes is not well understood. The goal of this study is to examine if specific regions of the brain moderate the relationship between the presence of MBI and performance on tasks of cognition. Data from the National Alzheimer’s Coordinating Center was utilized for this study. Participants (N=1,451) were included in our analyses if they were cognitively healthy or had mild cognitive impairment (MCI). Multiple domains of cognitive performance were evaluated. The neuroanatomical regions included hippocampus, caudal anterior cingulate (ACC), rostral ACC, entorhinal, and parahippocampal gray matter volume; and caudal ACC, rostral ACC, entorhinal, and parahippocampal mean cortical thickness. Hippocampal, entorhinal, and parahippocampal cortical gray matter volume moderated the relationship between MBI and performance on tasks of episodic memory. Left rostral ACC cortical gray matter volume and entorhinal and parahippocampal mean cortical thickness moderated the relationship between MBI and performance on language tasks. Hippocampi cortical gray matter volume also moderated the relationship between MBI and performance on processing speed tasks. Persons with smaller brain sizes in these areas were more negatively affected in these cognitive domains if they had MBI. These results suggest that the association between smaller brain volumes and cognition was stronger among persons with MBI. These findings suggest that older adults with MBI may perform worse on these tasks due to neurodegeneration that is present.

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The relationship between serum fatty-acid binding protein 4 level and lung function in Korean subjects with normal ventilatory function

BMC Pulmonary Medicine ◽

10.1186/s12890-016-0190-8 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Hye-Jeong Park ◽

Se Eun Park ◽

Cheol-Young Park ◽

Seong Yong Lim ◽

Won-Young Lee ◽

...

Keyword(s):

Fatty Acid ◽

Lung Function ◽

Fatty Acid Binding Protein ◽

Binding Protein ◽

Ventilatory Function ◽

Serum Fatty Acid ◽

Fatty Acid Binding ◽

Acid Binding Protein ◽

The Relationship

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Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

10.21203/rs.3.rs-34750/v3 ◽

2020 ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Consecutive Series ◽

Sectional Study ◽

Behavioral Impairment ◽

Cross Sectional ◽

Multivariable Logistic Regression ◽

Increased Risk ◽

The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a dementia risk syndrome characterized by later-life emergence of persistent neuropsychiatric symptoms, has yet to be elucidated. We aimed to evaluate the associations between MBI and frailty in older adults without dementia.Methods: In this cross-sectional study, a consecutive series of 137 older adults without dementia in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist (MBI-C) at a cut-off point of >8. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariable logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariable logistic regression analysis demonstrated that compared to those without MBI (MBI- status), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49-37.21, p = 0.02). Frailty and MBI were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status were associated with higher odds of cognitive impairment. MBI was significantly associated with an increased risk of having frailty in the absence of dementia. This association merits further study to identify potential strategies for the early detection, prevention and therapeutic intervention of frailty.

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