scholarly journals MO354PRELIMINARY EVIDENCE OF RIVASTIGMINE EFFICACY IN CKD RELATED MILD COGNITIVE IMPAIRMENT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Pasquale Mone ◽  
Antonella Pansini ◽  
Giovambattista Capasso ◽  
Davide Viggiano
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Common Finding ◽  
Control Group ◽  
Cognitive Screening ◽  
Paired Data ◽  
Electrolyte Disorders ◽  
Ckd Stage ◽  
Moca Score

Abstract Background and Aims Mild Cognitive Impairment (MCI) is a common finding in chronic kidney disease (CKD) patients. Indeed, CKD represents a relevant risk factor for developing dementia and MCI. Cholinesterase inhibitors, such as rivastigmine, are among the few drugs approved for the treatment of dementia and MCI. Rivastigmine is also used to treat vascular dementia because it protects subcortical brain structures. Data are scanty regarding the use of rivastigmine in CKD patients with MCI and are much needed to guide the therapy for MCI in this cohort of patients. Method This retrospective case-control study compared the effects of rivastigmine on cognitive functions in MCI patients with CKD (stage III-IV; n= 20) and without CKD (n=21, control group), comparable for the extent of cognitive impairment (indexed by Montreal Cognitive Assessment, MoCA), age (range 18-65 years), gender, weight, and comorbidities. Patients under treatment with rivastigmine and with a baseline MoCA score available were included in the study. Exclusion criteria were ictus, psychiatric or other neurological conditions, heart failure, liver failure, severe obesity, anemia, electrolyte disorders, cancer, dialysis, and other severe comorbidities. Laboratory test data (glycemia, cholesterol, hemoglobin, proteinuria, creatinine) were used to characterize the two populations. MCI was defined as a MoCA score between 21-26. The cognitive screening was available at baseline (before treatment) and during a follow-up in a range of three-six months after the start of the treatment. CKD was defined by eGFR < 60 mL/min/1.73m2. Results The follow-up timing for cognitive screening was not statistically different between the two cohorts. The control group (MCI without CKD) showed a small, significant improvement in the MoCA score after treatment (baseline MoCA: 22.9±0.5, follow-up MoCA: 23.5±0.5, p=0.02, t-test for paired data). At variance, the MCI-CKD group showed a significant improvement in the MoCA score (baseline MoCA=23±0.4, follow-up MoCA=24.3±0.4, p<0.05). Accordingly, the extent of improvement of MoCA score after rivastigmine was inversely correlated to the eGFR (r = -0.23). Conclusion A significant improvement in MoCA score accompanied treatment with rivastigmine in the CKD group. More extensive population studies are needed to verify the greater efficacy of Acetylcholinesterase inhibitors in this population.

scholarly journals 332 - Electroconvulsive therapy in older adults with major depression was not associated with cognitive decline during a 15-year follow-up

2020 ◽  
Vol 32 (S1) ◽  
pp. 91-91
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Major Depression ◽  
Cognitive Decline ◽  
Electroconvulsive Therapy ◽  
Antidepressant Treatment ◽  
Community Sample ◽  
Control Group

AUTHORS:Kerstin Johansson, Karolina Thömkvist, Ingmar Skoog and Sacuiu SF* (*presenter)OBJECTIVE:To determine the effects of electroconvulsive therapy (ECT) in major depression in relation to the development of dementia during long-term follow-up.METHOD:In an observational clinical prospective study of consecutive patients 70 years and older diagnosed with major depression at baseline 2000-2004 (n=1090), who were free of dementia and received antidepressant treatment, with or without ECT, we sought to determine if cognitive decline (mild cognitive impairment and dementia) during 15 -year follow-up was associated with receiving ECT at baseline. The control group was selected among the participants in the Gothenburg H70 Birth Cohort Studies matched by age group and sex 1:1.RESULTS:Among patients with affective syndromes 7% received ECT. During follow-up, 157 patients were diagnosed with dementia, equal proportions among those who received ECT (14.5%) and those who did not receive ECT (14.5%). The relation between ECT and cognitive decline remained non-significant irrespective antidepressive medication or presence of mild cognitive impairment at baseline.CONCLUSION:Preliminary results indicate that ECT was not associated with the development of cognitive decline in the long-term in a hospital-based cohort of 70+ year-olds. The results remain to verify against controls from a representative community sample.

“Camminando e Leggendo ...   Ricordo” (Walking and Reading ...   I Remember): Prevention of Frailty Through the Promotion of Physical Activity and Reading in People with Mild Cognitive Impairment. Results from the TREDEM Registry

2020 ◽  
Vol 77 (2) ◽  
pp. 689-699
Author(s):  
Maurizio Gallucci ◽  
Anna Paola Mazzarolo ◽  
Lucia Focella ◽  
Cinzia Piovesan ◽  
Manuela Mazzetto ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Older People ◽  
Intervention Program ◽  
Active Group ◽  
Control Group ◽  
Frailty Status ◽  
One Year

Background: Frailty is a condition of increased vulnerability to exogenous and endogenous stressors, which is correlated with aging, functional decline, institutionalization, hospitalization, and mortality. Given the multifaceted nature of frailty, programs aimed at its prevention are recommended to act on multiple domains. Objective: The present intervention program aimed at assessing the effects of combined physical and cognitive training in older people with mild cognitive impairment (MCI) and at investigating how their frailty status changed over one year of follow-up. Methods: Two-hundred and seven participants were recruited among outpatients of the Cognitive Impairment Center who agreed to receive a comprehensive assessment. Forty-six participants, who joined a structured program of physical activity and group readings for a period of one year, were defined as active. The remaining 161, who decided not to engage in those activities, were considered controls. In both groups, frailty status was assessed at baseline and over one year of follow-up. Results: Control participants showed twice the risk of becoming frail at 12 months compared with those in the active group. Participants in the active group had more than three times the probability of improving their frailty status compared with the control group from T0 to T12. Age and NPI scores were significantly associated with worsening frailty status. When analyses were restricted to participants who were robust at baseline, the frailty status varied significantly between groups over time. Conclusion: Findings of the present study confirm the beneficial effects of physical activity and reading to prevent frailty in older people with MCI.

scholarly journals Plasma Transthyretin as a Predictor of Amnestic Mild Cognitive Impairment Conversion to Dementia

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yi-Ting Tien ◽  
Wei-Ju Lee ◽  
Yi-Chu Liao ◽  
Wen-Fu Wang ◽  
Kai-Ming Jhang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Proportional Hazards ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Amnestic Mild Cognitive Impairment ◽  
Teaching Hospitals ◽  
Outcome Variable ◽  
Control Group

AbstractAmnestic mild cognitive impairment (MCI) is a prodromal stage of dementia, with a higher incidence of these patients progressing to Alzheimer’s disease (AD) than normal aging people. A biomarker for the early detection and prediction for this progression is important. We recruited MCI subjects in three teaching hospitals and conducted longitudinal follow-up for 5 years at one-year intervals. Cognitively healthy controls were recruited for comparisom at baseline. Plasma transthyretin (TTR) levels were measured by ELISA. Survival analysis with time to AD conversion as an outcome variable was calculated with the multivariable Cox proportional hazards models using TTR as a continuous variable with adjustment for other covariates and bootstrapping resampling analysis. In total, 184 MCI subjects and 40 sex- and age-matched controls were recruited at baseline. At baseline, MCI patients had higher TTR levels compared with the control group. During the longitudinal follow-ups, 135 MCI patients (73.4%) completed follow-up at least once. The TTR level was an independent predictor for MCI conversion to AD when using TTR as a continuous variable (p = 0.023, 95% CI 1.001–1.007). In addition, in MCI converters, the TTR level at the point when they converted to AD was significantly lower than that at baseline (328.6 ± 66.5 vs. 381.9 ± 77.6 ug/ml, p < 0.001). Our study demonstrates the temporal relationship between the plasma TTR level and the conversion from MCI to AD.

Efficacy of a cognitive intervention program in patients with mild cognitive impairment

2013 ◽  
Vol 25 (5) ◽  
pp. 825-831 ◽  
Author(s):  
Galeno J. Rojas ◽  
Veronica Villar ◽  
Monica Iturry ◽  
Paula Harris ◽  
Cecilia M. Serrano ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Training ◽  
Intervention Program ◽  
Cognitive Strategies ◽  
Cognitive Intervention ◽  
Control Group ◽  
Functional Measures ◽  
One Year

ABSTRACTBackground: Mild cognitive impairment (MCI) is a transitional state between normal aging and dementia. Identifying this condition would allow early interventions that may reduce the rate of progression to Alzheimer's disease (AD). We examined the efficacy of a six-month cognitive intervention program (CIP) in patients with MCI and to assess patients’ condition at one-year follow-up.Methods: Forty-six MCI participants assessed with neuropsychological, neurological, neuropsychiatry, and functional procedures were included in this study and followed up during a year. The sample was randomized into two subgroups: 24 participants (the “trained group”) underwent the CIP during six months while 22 (control group) received no treatment. Sixteen participants dropped out of the study. The intervention focused on teaching cognitive strategies, cognitive training, and use of external aids, in sessions of two hours, twice per week for six months. Cognitive and functional measures were used as primary outcome and all were followed up at one year.Results: The intervention effect (mean change from baseline) was significant (p < 0.05) on the Mini-Mental State Examination (1.74), the Clinical Dementia Rating Scale (0.14), the Boston Naming Test (2.92), block design (−13.66), matrix reasoning (−3.07), and semantic fluency (−3.071) tasks. Four patients (one trained and three controls) progressed to dementia after one year of follow-up.Conclusions: These results suggest that persons with MCI can improve their performance on cognitive and functional measures when provided with early cognitive training and it could persist in a long-term follow-up.

scholarly journals Study on Adjuvant Medication for Patients with Mild Cognitive Impairment Based on VR Technology and Health Education

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Huiling Liu ◽  
Xiaona Yang ◽  
Xinkun Wang ◽  
Xiaoyu Yang ◽  
Xusheng Zhang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Health Education ◽  
Lung Function ◽  
Walking Distance ◽  
Control Group ◽  
Study Group ◽  
Rehabilitation Training ◽  
Moca Score

In order to improve the efficiency of auxiliary medication for patients with mild cognitive impairment, this paper proposes a method based on VR technology and health education. Sixty elderly patients with COPD and MCI admitted to a hospital from January 2019 to February 2020 were randomly divided into a control group and study group, with 50 cases in each group. On the basis of conventional drug therapy, health education, and respiratory muscle training, patients in the control group received routine lung rehabilitation training, while patients in the study group received lung rehabilitation training using the BioMaster virtual scene interactive rehabilitation training system. Both groups continued training for 12 weeks. Lung function indexes, 6-minute walking distance, COPD assessment test (CAT) score, and Montreal Cognitive Function Assessment Scale (MoCA) score were compared between the 2 groups before training and 4, 8, and 12 weeks after training. The experimental results show that, in the study group, the percentage of FEV1 in the predicted value at 8 weeks after training, the percentage of FEV1 in the predicted value at 12 weeks after training, and FEV1/FVC were higher than those in the control group ( P < 0.05 ). There was no significant difference in 6-minute walking distance, CAT score, and MoCA score between the two groups before training ( P > 0.05 ). Twelve weeks after training, patients in the study group had a longer 6-minute walking distance, a lower CAT score, and a higher MoCA score than those in the control group ( P < 0.05 ). It is proved that the application of virtual reality technology in lung rehabilitation training of elderly COPD patients with MCI is effective, which can effectively improve the lung function, cognitive function, and exercise tolerance of the patients and reduce the symptoms of dyspnea and the efficiency of medication.

scholarly journals Relationship Between Orthostatic Hypotension and Cognitive Functions in Multiple System Atrophy: A Longitudinal Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Sofia Cuoco ◽  
Immacolata Carotenuto ◽  
Arianna Cappiello ◽  
Sara Scannapieco ◽  
Maria Claudia Russillo ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Multiple System Atrophy ◽  
Orthostatic Hypotension ◽  
Cognitive Functions ◽  
Cognitive Status ◽  
Normal Cognition ◽  
Moca Score ◽  
Over Time

Introduction: The aim of this study is to investigate the impact of orthostatic hypotension (OH) on cognitive functions in patients with multiple system atrophy (MSA) followed over time.Methods: Thirty-two MSA patients were enrolled and underwent a comprehensive neuropsychological battery; at baseline (T0) 15 out of 32 patients presented OH, assessed by means of orthostatic standing test. All patients underwent a follow-up (T1) evaluation 12 months after baseline. Thirteen out of 32 patients also underwent a second follow-up (T2) evaluation at 24 months. Changes over time on different neuropsychological tasks were compared between patients with and without OH by means of Mann-Whitney's U-test. Moreover, clinical categories of normal cognition, mild cognitive impairment, and dementia were determined, and changes at T1 and T2 in global cognitive status were compared between patients with and without OH.Results: At T0, patients with OH had better performance on words/non-words repetition task (p = 0.02) compared to patients without OH. Compared to patients without OH, patients with OH performed worse on semantic association task (p &lt; 0.01) at T1 and on Stroop test-error effect (p = 0.04) at T2. The percentage of patients with worsened cognitive status at T1 was higher among patients with OH than among patients without OH (93 vs. 59%, p = 0.03). OH (β = −4.67, p = 0.01), education (β = 0.45, p = 0.02), age (β = 0.19, p = 0.03), and Montreal Cognitive Assessment battery (MOCA) score at T0 (β = −0.26, p = 0.04) were significant predictors of global cognitive status worsening at T1.Discussion: We found that global cognitive status worsened at 1-year follow-up in 93% of patients with OH, and OH, along with age, education, and MOCA score, predicted cognitive worsening over time. To clarify the relationship between OH and cognitive dysfunction in MSA, we suggest the use of clinical categories of normal cognition, mild cognitive impairment, and dementia in further longitudinal studies on MSA patients with and without OH.

scholarly journals EEG alpha peak frequency analysis during memorizing of figures in patients with mild cognitive impairment

2009 ◽  
Vol 67 (2b) ◽  
pp. 428-431 ◽  
Author(s):  
Magali Taimo Schmidt ◽  
Renato Anghinah ◽  
Luis Fernando Basile ◽  
Oreste Forlenza ◽  
Wagner Faride Gattaz
Keyword(s):  
Spectral Analysis ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Peak Frequency ◽  
Cognitive Stimulation ◽  
Control Group ◽  
Psychiatric Institute ◽  
Eeg Alpha ◽  
The University

OBJECTIVE: To investigate spectral analysis of electroencephalograms (EEG) for the alpha frequency band during rest and cognitive stimulation in healthy adults and individuals with mild cognitive impairment. METHOD: We analyzed 56 EEGs from 28 patients, 7 men and 21 women, 12 of whom (40%) were controls, 16 patients with mild cognitive impairment (60%). Ages ranged from 61 to 83 years. All individuals were patients in the Psycho-geriatric Out-patients Clinic of LIM-27, of the Psychiatric Institute of the Clinicas Hospital of the Faculty of Medicine of the University of São Paulo, IPq-HCFMUSP, between 2004 and 2007. Each patient underwent two exams with an interval of at least six months between them. During the exam, performed after a period of wakefulness and rest, the patients memorized series of pictures. RESULTS: Analysis of spectral potential both at rest and during the memorizing task showed no statistical differences between baseline and final recordings. CONCLUSION: Spectral analysis of EEGs showed coherent results with the clinical stability of the patients evaluated but was unable to distinguish between the control group and patients with MCI. Future studies should include a larger sample and a longer follow up.

scholarly journals Insulin resistance is a risk factor for mild cognitive impairment in elderly adults with T2DM

2019 ◽  
Vol 14 (1) ◽  
pp. 255-261
Author(s):  
Hongjun Zhao ◽  
Chenglong Wu ◽  
Xiaoping Zhang ◽  
Liping Wang ◽  
Jianhong Sun ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Risk Factor ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Roc Curve ◽  
Control Group ◽  
Elderly Adults ◽  
Control Groups ◽  
And Control ◽  
Moca Score

AbstractObjectiveThe aim of this study was to investigate the clinical effects of insulin resistance (IR) in the development of mild cognitive impairment (MCI) in elderly adults with Type 2 diabetes mellitus (T2DM).MethodsSeventy-eight patients with T2DM were recruited and divided into MCI group (<26, n=48) and normal group (≥26, n=30) according to the Montreal Cognitive Assessment (MoCA) score. The fasting plasma glucose (FPG), HbA1c, and fasting plasma C-peptide (FPC) were examined and compared between the two groups. The Pancreatic islets function (HOMA-islet) and Insulin Resistance Index (HOMA-IR) were also calculated for the two groups. Using the HOMA-IR and HOMA-islet as the reference, the predicted values for MCI in T2DM patients were calculated by sensitivity, specificity and area under the receiver operating characteristic (ROC) curve.ResultsThe MoCA scores were statistically different between the MCI and control groups (23.79±1.15 vs 28.50±1.01, p<0.05). The serum FPG and FPC were 10.38±2.36 mmol/L and 0.79±0.34 ng/mL in the MCI group which were significant different from those of the control group (8.96±2.55 mmol/L and 1.04±0.38 ng/mL; p<0.05). The HOMA-IR and HOMA-islet were 10.08±2.64 and 94.67±29.12 for the MCI group and 8.16±2.46 and 130.30±38.43 for the control group; both were statistically different (p<0.05). The serum HbA1c was 11.02±2.59% and 9.37±2.00% for the MCI and control groups (significantly different with p<0.5). A significant positive correlation was found between MoCA score and HOMA-islet (rpearson=0.44; p<0.001). A significant negative correlation existed between MoCA score and serum HbA1c (r=-0.25; p=0.03). The areas under the ROC curve were 0.70 (0.57~0.82), 0.69 (0.57~0.81), 0.69 (0.57~0.80), 0.72 (0.60~0.84), 0.72 (0.60~0.84) and 0.76 (0.65~0.88) respectively for FPG, FPC, HbA1c, HOMA-IR and HOMA-islet.ConclusionInsulin resistance is a risk factor for mild cognitive impairment and can be a biomarker for prediction of MCI in patients with T2DM.

scholarly journals THE ROSAS COHORT: A PROSPECTIVE, LONGITUDINAL STUDY OF BIOMARKERS FOR ALZHEIMER’S DISEASE. STRATEGY, METHODS AND INITIAL RESULTS

2017 ◽  
pp. 1-11
Author(s):  
A. de Mauléon ◽  
M. Soto ◽  
V. Kiyasova ◽  
J. Delrieu ◽  
I. Guignot ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Urine Samples ◽  
Control Group ◽  
Dementia Of Alzheimer’S Type ◽  
Blood And Urine Samples ◽  
Baseline Characteristics

Objective: The aims of the Research Of biomarkers in Alzheimer’s diseaSe (ROSAS) study were to determine the biofluid and imaging biomarkers permitting an early diagnosis of Alzheimer’s disease and better characterisation of cognitive and behavioural course of the pathology. This paper outlines the overall strategy, methodology of the study, baseline characteristics of the population and first longitudinal results from the ROSAS cohort. Methods: Longitudinal prospective monocentric observational study performed at the Alzheimer’s disease Research centre in Toulouse. A total of 387 patients were studied and analyzed in 3 groups: 184 patients with dementia of Alzheimer’s type, 96 patients with memory disorders without dementia (Mild Cognitive Impairment) and 107 patients without abnormal memory tests (control group), and were followed up during 4 years. Patient’s sociodemographic characteristics, risk factors, medical conditions, previous and current medications, neuropsychological assessment and overall cognitive status were recorded. Blood and urine samples were collected at every year, Magnetic Resonance Imaging were performed at inclusion, after one year of follow-up and at the end of the study. Results: At baseline, three different groups of the cohort differed interestingly in age, level of education, and in percentage of ApoEε4 carriers whereas the history of cardiovascular and endocrine pathologies were similar among the groups. During the follow-up period (3-4 years) 42 mild cognitive impairment patients (43.8%) progressed to dementia, 7 controls progressed into mild cognitive impairment and 1 patient in the control group converted from mild cognitive impairment group to dementia of Alzheimer’s type group. During the first year of follow up, the incidence of progression from mild cognitive impairment to dementia of Alzheimer’s type was 12.7 per 100, during the second year 33.9 per 100 and 46.7 per 100 for the third year. Conclusion: This paper presents the baseline characteristics of the unique French prospective monocenter study in which the natural course of dementia of Alzheimer’s type was evaluated. Future analysis of blood and urine samples collection from the ROSAS study will permit to identify possible biofluid biomarkers predicting the early stages of the dementia of Alzheimer’s type and risk of progression from Mild Cognitive Impairment to Alzheimer’s disease.

scholarly journals Effect of Nursing Intervention on Improving the Cognitive Function of Patients with Mild Cognitive Impairment

2021 ◽  
Vol 5 (5) ◽  
pp. 162-166
Author(s):  
Li Sun ◽  
Zhenzhu Shang
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Research Group ◽  
Reference Group ◽  
Nursing Intervention ◽  
Significant Difference ◽  
Moca Score

Objective: To explore the effect of nursing intervention on improving the cognitive function of patients with mild cognitive impairment. Methods: Sixty patients with mild cognitive impairment in Weifang Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were randomly selected for this study. They were divided into two groups: a reference group (routine follow-up and daily health education) and a research group (nursing intervention based on the reference group). Results: Before nursing, there was no significant difference in the MoCA, MMSE, ADL, SDS, and SAS scores between the two groups (p > 0.05). After intervention, the MOCA score and MMSE score of the research group were lower than those of the reference group, the ADL score of the research group was higher than that of the reference group, and the quality-of-life score of the research group was also higher than that of the reference group (p < 0.05). Conclusion: Early nursing intervention for patients with mild cognitive impairment can effectively improve their cognitive functions and daily abilities.

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