Cognitive function in elderly patients with Chronic Kidney disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Yumna A Elgazzar ◽  
Ramy M Mahmoud ◽  
Heba Y Kamel ◽  
Tomader T Abdel Rahman ◽  
Hala S Sweed
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Executive Functions ◽  
Neuropsychological Battery ◽  
Language Functions

Abstract Background Many elderly patients with Chronic Kidney disease (CKD) develop cognitive impairment and dementia. Cognitive impairment impacts CKD patients negatively by functional dependence and recurrent hospitalization. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery was originally developed to identify early Alzheimer’s disease, but it has become a widely used instrument to assess different levels & domains of cognitive and executive functions. Aim the aim of the study was to assess cognitive function in elderly patients with CKD. Patients and Methods one hundred CKD patients were recruited from outpatient clinics of Ain Shams University hospital. CERAD neuropsychological battery was used to measure cognitive functions in different domains (language functions, verbal learning, visuospatial functions, delayed recall, memory consolidation, recognition memory, and executive functions). Results CKD patients had low mean verbal fluency and mean MMSE while language functions score hadn’t been affected. There was a significant positive correlation (p < 0.001) between the mean eGFR and the CERAD total score. Conclusion This study contributes to the belief that an association exists between renal impairment and cognition, CERAD total score in CKD patients was inversely correlated to eGFR. Age and educational level significantly affect cognitive performance.

scholarly journals Neurotrophic Treatment Initiated During Early Postnatal Development Prevents the Alzheimer-Like Behavior and Synaptic Dysfunction

2021 ◽  
pp. 1-16
Author(s):  
Wei Wei ◽  
Yinghua Liu ◽  
Chunling Dai ◽  
Narjes Baazaoui ◽  
Yunn-Chyn Tung ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Synaptic Plasticity ◽  
Cognitive Function ◽  
Early Development ◽  
Neurodegenerative Disorder ◽  
Synaptic Dysfunction ◽  
Early Postnatal Development ◽  
Wild Type Female

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by impairments in synaptic plasticity and cognitive performance. Cognitive dysfunction and loss of neuronal plasticity are known to begin decades before the clinical diagnosis of the disease. The important influence of congenital genetic mutations on the early development of AD provides a novel opportunity to initiate treatment during early development to prevent the Alzheimer-like behavior and synaptic dysfunction. Objective: To explore strategies for early intervention to prevent Alzheimer’s disease. Methods: In the present study, we investigated the effect of treatment during early development with a ciliary neurotrophic factor (CNTF) derived peptidergic compound, P021 (Ac-DGGLAG-NH2) on cognitive function and synaptic plasticity in 3xTg-AD transgenic mouse model of AD. 3xTg-AD and genetic background-matched wild type female mice were treated from birth to postnatal day 120 with P021 in diet or as a control with vehicle diet, and cognitive function and molecular markers of neuroplasticity were evaluated. Results: P021 treatment during early development prevented cognitive impairment and increased expressions of pCREB and BDNF that activated downstream various signaling cascades such as PLC/PKC, MEK/ERK and PI3K/Akt, and ameliorated synaptic protein deficit in 4-month-old 3xTg-AD mice. Conclusion: These findings indicate that treatment with the neurotrophic peptide mimetic such as P021 during early development can be an effective therapeutic strategy to rescue synaptic deficit and cognitive impairment in familial AD and related tauopathies.

scholarly journals Saffron for mild cognitive impairment and dementia: a systematic review and meta-analysis of randomised clinical trials

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zahra Ayati ◽  
Guoyan Yang ◽  
Mohammad Hossein Ayati ◽  
Seyed Ahmad Emami ◽  
Dennis Chang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Daily Living ◽  
Randomised Clinical Trials ◽  
Disease Assessment ◽  
Significant Difference

Abstract Background Saffron (stigma of Crocus sativus L.) from Iridaceae family is a well-known traditional herbal medicine that has been used for hundreds of years to treat several diseases such as depressive mood, cancer and cardiovascular disorders. Recently, anti-dementia property of saffron has been indicated. However, the effects of saffron for the management of dementia remain controversial. The aim of the present study is to explore the effectiveness and safety of saffron in treating mild cognitive impairment and dementia. Methods An electronic database search of some major English and Chinese databases was conducted until 31st May 2019 to identify relevant randomised clinical trials (RCT). The primary outcome was cognitive function and the secondary outcomes included daily living function, global clinical assessment, quality of life (QoL), psychiatric assessment and safety. Rev-Man 5.3 software was applied to perform the meta-analyses. Results A total of four RCTs were included in this review. The analysis revealed that saffron significantly improves cognitive function measured by the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and Clinical Dementia Rating Scale-Sums of Boxes (CDR-SB), compared to placebo groups. In addition, there was no significant difference between saffron and conventional medicine, as measured by cognitive scales such as ADAS-cog and CDR-SB. Saffron improved daily living function, but the changes were not statistically significant. No serious adverse events were reported in the included studies. Conclusions Saffron may have the potential to improve cognitive function and activities of daily living in patients with Alzheimer’s disease and mild cognitive impairment (MCI). However, due to limited high-quality studies there is insufficient evidence to make any recommendations for clinical use. Further clinical trials on larger sample sizes are warranted to shed more light on its efficacy and safety.

scholarly journals P0796THE PREVALENCE AND INCIDENCE OF COGNITIVE IMPAIRMENT IN A COHORT OF CHRONIC KIDNEY DISEASE PATIENTS WITH CONCOMITANT DIABETES ATTENDING A SPECIALIST NEPHROLOGY CLINIC

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mick Kumwenda ◽  
Peter Hobson
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Kidney Disease ◽  
Incidence Rate ◽  
Neuropsychological Assessment ◽  
Current Investigation ◽  
Dsm 5 ◽  
Crude Prevalence

Abstract Background and Aims Chronic kidney disease (CKD) is a global healthcare problem associated with several comorbid conditions including, cardiovascular disease, and diabetes, all of which are strong risk factors for the development of significant cognitive impairment. We recently reported the baseline outcomes of our older adult cohort with mild to moderate CKD (stages 3-4) and diabetes, where 48% were found to have a cognitive impairment ranging from mild to severe symptoms. [1] This study reports the outcomes at 36-months post baseline of the prevalence and incidence of cognitive impairment in this cohort the patients who at baseline were considered to have normal cognitive function. Method Cognitive function was assessed in patients over aged 55 years, with an estimated glomerular filtration rate < 45ml/min/1.73m 2, attending a renal and diabetes outpatient clinic, at baseline and at 36-months. The diagnosis of cognitive impairment was based upon patient and informant interview, case note review, neuropsychological assessment and application of Diagnostic and Statistical Manual of Mental disorders version 5 (DSM-5) and Petersen’s criteria for mild cognitive impairment (MCI). The incidence of cognitive impairment was calculated by dividing the number of new cases during study follow-up, by the person-time at risk throughout the observation period. Since it is not possible to precisely determine when a person actually develops cognitive impairment between baseline and follow-up, the midpoint of time between having normal cognition and becoming a case is assumed. Results Ninety-two patients without cognitive impairment at baseline, were included in this investigation (mean age of 75.8 + 9.1; 49 males: 43 female). Upon neuropsychological assessment and the application of DSM-5 criteria at follow-up, it was revealed that 25/92 (27%) of the cohort had developed a cognitive impairment ranging from MCI (n=19), to major symptoms (n = 6). The crude prevalence for MCI was 20.6%, and for dementia it was 6.5%. The total person years in the study were 237.38 years, with an overall incidence rate of 10.53 (95% Confidence interval 6.82-15.55) per 100 person-years. Conclusion This longitudinal cohort investigation reports the prevalence and incidence of new cases of cognitive impairment ranging from MCI to dementia in CKD. The crude prevalence in the current investigation for the development of cognitive impairment was 27%. The overall incidence rate for new cases of NCD was just over 10%. In other words, for every 100 patients in our current investigation we would estimate that around 10 will develop some a cognitive impairment ranging from MCI to dementia per year. Our findings from this and our previous investigation suggest that a significant number of CKD patients are at risk for the development of significant neurodegenerative conditions and in view of this cognitive function should be screened and monitored routinely in clinical practice. This will assist with appropriate health service planning, service development, clinical interventions and the assessment of the effectiveness of new and existing treatments services.

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