Determinants of the Higher Prevalence and Severity of Subjective Cognitive Impairment in Cancer Patients Compared to Healthy Subjects: Fatigue and Stress

2020 ◽  
pp. 105477382095747
Author(s):  
Hee-Ju Kim ◽  
Ivo Abraham
Keyword(s):  
Cognitive Impairment ◽  
Sleep Disturbance ◽  
Cancer Patients ◽  
Prevalence Rate ◽  
Healthy Subjects ◽  
Major Determinant ◽  
Healthy Controls ◽  
Subjective Cognitive Impairment ◽  
Fatigue Stress

This study examined whether (a) cancer patients in two cohorts reported greater subjective cognitive impairment (SCI) in prevalence and severity than noncancer healthy controls; and (b) selected psychoneurological factors (fatigue, stress, and sleep disturbance) contribute to such differences. Data from 60 prechemotherapy cancer patients, 81 active-chemotherapy cancer patients, and 116 noncancer healthy controls were analyzed using hierarchical regressions. The prevalence rate of SCI was higher in the prechemotherapy cancer cohort (41.6%) and in the active-chemotherapy cancer cohort (46.9%) than in healthy controls (21.5%; p < .001). SCI severity was also higher in two cancer cohorts than noncancer controls ( p < .001). The two cancer cohorts were similar to each other in severity and prevalence of SCI. The two cancer cohorts experienced higher fatigue, stress, and sleep disturbance than healthy controls. After controlling for psychoneurological factors, however, the two cancer cohorts did not differ from healthy controls in experiencing SCI in prevalence and severity. Psychoneurological factors may be a major determinant of the higher prevalence and severity of SCI in cancer patients.

scholarly journals A community-based case–control study of prevalence and pattern of cognitive impairments in patients with epilepsy residing in South-Eastern Nigeria

2016 ◽  
Vol 07 (03) ◽  
pp. 405-411 ◽  
Author(s):  
Eugene O. Arinzechi ◽  
Olubunmi A. Ogunrin ◽  
Cosmas M. Nwosu ◽  
Paul O. Nwani ◽  
Kelechi O. Enwereji ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Prevalence Rate ◽  
Cognitive Impairments ◽  
Sub Saharan Africa ◽  
Cognitive Test ◽  
Computer Assisted ◽  
Healthy Controls ◽  
Community Screening ◽  
South Eastern ◽  
Patients With Epilepsy

ABSTRACT Background: Epilepsy is the commonest neurological disorder encountered in Sub-Saharan Africa. The quality of life of patients with epilepsy (PWEs) is adversely affected by cognitive impairments. Aim: This study investigated the prevalence and pattern of cognitive impairments in PWE in Ukpo community located in a South-Eastern state in Nigeria using Community Screening Interview for Dementia (CSID) and a computer-assisted cognitive test battery (FePsy). Methods and Patients: Fifty-one PWEs were studied and compared with 51 age-, sex-and level of education-matched healthy controls. Diagnosis of epilepsy was confirmed clinically with eye-witness corroboration. Sociodemographic data and information on epilepsy variables were obtained with the aid of a questionnaire. Cognitive domains assessed include language, memory, orientation, attention, psychomotor speed and constructional praxis. Results: The prevalence rate of cognitive impairment using total CSID score was 19.6%. Analysis of CSID scores revealed significant impairment in language (17.6%), memory (29.4%), orientation (15.7%), attention (7.8%) and constructional praxis (15.7%) compared to healthy controls. A similar pattern was observed with FePsy but with better sensitivity indices for detecting cognitive impairment. Conclusion: This study indicated significant prevalence rate of cognitive impairment among treatment-naïve PWE with profound affectation of memory, mental speed and language. In addition, the FePsy was found to be more sensitive and specific in assessment of cognitive function in PWE.

scholarly journals Effects of Acupuncture on Cancer-Related Cognitive Impairment in Chinese Gynecological Cancer Patients: A Pilot Cohort Study

2018 ◽  
Vol 17 (3) ◽  
pp. 737-746 ◽  
Author(s):  
Yingchun Zeng ◽  
Andy S. K. Cheng ◽  
Ting Song ◽  
Xiujie Sheng ◽  
Shaojing Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
White Matter ◽  
Pilot Study ◽  
Cancer Patients ◽  
Gynecological Cancer ◽  
Structural Connectivity ◽  
Control Group ◽  
Healthy Controls ◽  
Neurocognitive Tests

Background: Among women in China, gynecological cancers are the second most common cancers after breast cancer. Cancer-related cognitive impairment (CRCI) has emerged as a significant problem affecting gynecological cancer survivors. While acupuncture has been used in different aspects of cancer care, the possible positive effects of acupuncture on cognitive impairment have received little attention. This study hypothesized that patients would demonstrate lower neurocognitive performance and lower structural connectivity compared to healthy controls. This pilot study also hypothesized that acupuncture may potentially be effective in treating CRCI of cancer patients by increasing brain structural connectivity and integrity. Methods: This prospective cohort study consisted of 3 stages: the first stage included a group of gynecological cancer patients and a group of age-matched healthy controls. This baseline stage used a core set of neurocognitive tests to screen patients with cognitive impairment and used a multimodal approach of brain magnetic resonance imaging (MRI) to explore the possible neurobiological mechanism of cognitive impairment in cancer patients, comparing the results with a group of noncancer controls. The second stage involved assigning CRCI patients into the acupuncture intervention group, while patients without CRCI were assigned into the cancer control group. The third stage was a postintervention assessment of neurocognitive function by the same set of neurocognitive tests at baseline. To explore the possible neurobiological basis of acupuncture for treating CRCI, this study also used a multimodal MRI approach to assess changes in brain structural connectivity, and neurochemical properties in patients at pre- and postacupuncture intervention. Results: This study found that the prevalence of cognitive impairment in Chinese gynecological cancer patients at diagnosis was 26.67%. When investigating the microstructural white matter in the brain, diffusion tensor imaging data in this study indicated that premorbid cognitive functioning (before clinical manifestations become evident) has already existed, as the global and local connectome properties in the entire patient group were lower than in the healthy control group. Using magnetic resonance spectroscopy, this study indicated there was a significant reduction of relative concentration of NAA ( N-acetyl aspartate) in the left hippocampus, comparing these results with healthy controls. Regarding the effects of acupuncture on reducing CRCI, patients in the acupuncture group reported better neurocognitive test performance after matching for age, menopausal status, cancer stage, and chemotherapy regimen dosage. On a microstructural level, acupuncture’s ability to reduce CRCI may be attributed to a reduction in demyelination and an enhancement of the neuronal viability of white matter in the hippocampus. Conclusion: This pilot study indicates that acupuncture is a promising intervention in treating CRCI in gynecological cancer patients undergoing chemotherapy; however, it requires evaluation in larger randomized controlled studies to definitively assess its benefit. By using a multimodal imaging approach, this pilot study also provides novel insights into the neurobiological basis of cognitive impairment on the human brain that has been induced by cancer and/or its treatment.

scholarly journals Dual-task tests discriminate between dementia, mild cognitive impairment, subjective cognitive impairment, and healthy controls – a cross-sectional cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hanna B. Åhman ◽  
Ylva Cedervall ◽  
Lena Kilander ◽  
Vilmantas Giedraitis ◽  
Lars Berglund ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Early Stage ◽  
Cognitive Test ◽  
Healthy Controls ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Single Task ◽  
Subjective Cognitive Impairment

Abstract Background Discrimination between early-stage dementia and other cognitive impairment diagnoses is central to enable appropriate interventions. Previous studies indicate that dual-task testing may be useful in such differentiation. The objective of this study was to investigate whether dual-task test outcomes discriminate between groups of individuals with dementia disorder, mild cognitive impairment, subjective cognitive impairment, and healthy controls. Methods A total of 464 individuals (mean age 71 years, 47% women) were included in the study, of which 298 were patients undergoing memory assessment and 166 were cognitively healthy controls. Patients were grouped according to the diagnosis received: dementia disorder, mild cognitive impairment, or subjective cognitive impairment. Data collection included participants’ demographic characteristics. The patients’ cognitive test results and diagnoses were collected from their medical records. Healthy controls underwent the same cognitive tests as the patients. The mobility test Timed Up-and-Go (TUG single-task) and two dual-task tests including TUG (TUGdt) were carried out: TUGdt naming animals and TUGdt months backwards. The outcomes registered were: time scores for TUG single-task and both TUGdt tests, TUGdt costs (relative time difference between TUG single-task and TUGdt), number of different animals named, number of months recited in correct order, number of animals per 10 s, and number of months per 10 s. Logistic regression models examined associations between TUG outcomes pairwise between groups. Results The TUGdt outcomes “animals/10 s” and “months/10 s” discriminated significantly (p < 0.001) between individuals with an early-stage dementia diagnosis, mild cognitive impairment, subjective cognitive impairment, and healthy controls. The TUGdt outcome “animals/10 s” showed an odds ratio of 3.3 (95% confidence interval 2.0–5.4) for the groups dementia disorders vs. mild cognitive impairment. TUGdt cost outcomes, however, did not discriminate between any of the groups. Conclusions The novel TUGdt outcomes “words per time unit”, i.e. “animals/10 s” and “months/10 s”, demonstrate high levels of discrimination between all investigated groups. Thus, the TUGdt tests in the current study could be useful as complementary tools in diagnostic assessments. Future studies will be focused on the predictive value of TUGdt outcomes concerning dementia risk for individuals with mild cognitive impairment or subjective cognitive impairment.

scholarly journals Correlates of Sleep Disturbance among Older Adults with Mild Cognitive Impairment: A Cross-Sectional Study

2020 ◽  
Vol 17 (13) ◽  
pp. 4862
Author(s):  
Dan Song ◽  
Doris S. F. Yu ◽  
Qiuhua Sun ◽  
Guijuan He
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sleep Disturbance ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Comorbidity Burden

Individuals with mild cognitive impairment (MCI) are at high risk for dementia development. Sleep disturbance is often overlooked in MCI, although it is an important risk factor of cognitive decline. In the absence of a cure for dementia, managing the risk factors of cognitive decline in MCI is likely to delay disease progression. To develop interventions for sleep disturbance in MCI, its related factors should be explored. This study aimed to identify and compare the correlates of sleep disturbance in older adults with MCI and those in cognitively healthy older adults. A comparative cross-sectional study was adopted. Data were obtained from 219 Chinese community-dwelling older adults (female: 70.3%), which consisted of 127 older adults with MCI and 92 age-matched cognitively healthy controls. The candidate correlates of sleep disturbance included socio-demographic correlates, health-related factors, lifestyle-related factors and psychological factor. Descriptive, correlational and regression statistics were used for data analysis. The prevalence of sleep disturbance in MCI was 70.1% compared to that of 56.5% in cognitively healthy controls (p < 0.001). The multivariate analysis indicated that, in participants with MCI, depressive symptoms (Beta = 0.297, p = 0.001), comorbidity burden (Beta = 0.215, p = 0.012) and physical activity (Beta = −0.297, p = 0.001) were associated with sleep disturbance. However, in the cognitively healthy controls, only depressive symptoms (Beta = 0.264, p = 0.028) and comorbidity burden (Beta = 0.361, p = 0.002) were associated with sleep disturbance. This finding highlights that sleep disturbance is sufficiently prominent to warrant evaluation and management in older adults with MCI. Furthermore, the findings elucidate several important areas to target in interventions aimed at promoting sleep in individuals with MCI.

scholarly journals The Value of Urinary RBP4 in The Diagnosis of FSGS and other Renal Diseases.

2020 ◽  
Author(s):  
Karolina Marek-Bukowiec ◽  
Andrzej Konieczny ◽  
Krzysztof Ratajczyk ◽  
Katarzyna Macur ◽  
Paulina Czaplewska ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Cancer Patients ◽  
Renal Cell ◽  
Healthy Subjects ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Healthy Controls ◽  
Retinol Binding Protein 4

Abstract BackgroundFocal segmental glomerulosclerosis (FSGS) is the leading cause of chronic renal failure worldwide. Unequivocal diagnosis of FSGS can only be made with a renal biopsy, which is an invasive, risk-associated medical procedure. The discovery of non-invasive molecular biomarkers for the diagnosis of FSGS still remains an important scientific goal. This study examines the urinary proteome profile of FSGS patients and reference groups, in order to identify urinary protein expression alterations indicative of FSGS. Methods Urine samples were collected from subjects representing FSGS, IgA nephropathy (IgAN), clear cell renal cell carcinoma (ccRCC), chromophobe renal cell carcinoma (chRCC), and healthy control group, respectively. The samples were pooled and subjected to SWATH-MS proteomics analysis. ELISA was utilized to validate the expression level of Retinol-binding protein 4 (uRBP4) in 130 urine supernatant samples (21 FSGS, 20 IgAN, 31 ccRCC, 21 chRCC, 7 prostate cancer patients and 30 healthy volunteers).ResultsThe MS study identified 194 (FSGS), 179 (IgAN), 271 (ccRCC), 255 (chRCC), and 275 (healthy controls) urinary proteins. The comparative proteomic analysis revealed that Retinol-binding protein 4 clearly discriminates FSGS from the rest of the groups. Increased levels of uRBP4 in FSGS urine specimens were also detected by ELISA (FSGS vs IgAN p=0.0244, FSGS vs ccRCC p=0.004, FSGS vs chRCC p=0.013, FSGS vs prostate cancer p=0.02, FSGS vs healthy controls p<0.00001). Significantly elevated levels of uRBP4 were also observed for IgAN, ccRCC and chRCC versus healthy individuals.ConclusionsUrinary RBP4 protein is significantly upregulated in FSGS in comparison to IgAN, ccRCC, chRCC, prostate cancer patients and healthy subjects. Determining FSGS diagnosis based on uRBP4 expression alone is not possible. Specific uRBP4 concentration cut-off can be applied to accurately distinguish individuals with renal disorder (in general) from healthy subjects. Thus, urinary RBP4 could serve as a screening biomarker identifying people at risk of renal disorders, who should undergo more detailed diagnostics.

scholarly journals Chemotherapy-related subjective cognitive impairment in breast cancer patients in semi-rural South Africa

2021 ◽  
Vol 26 ◽  
Author(s):  
Nicholas M. Keetile ◽  
Elzbieta Osuch ◽  
Antonio G. Lentoor
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cancer Patients ◽  
Current Evidence ◽  
Breast Cancer Patients ◽  
Rural South ◽  
Subjective Cognitive Impairment ◽  
Treatment Groups ◽  
Therapeutic Benefits ◽  
African Patients

Background: Breast cancer is the most commonly diagnosed cancer amongst women worldwide. Whilst current evidence indicates the therapeutic benefits from the use of chemotherapy, self-perceived cognitive difficulties emerged as a frequent occurrence during and after chemotherapy treatment in breast cancer patients.Aim: The current study sought to investigate self-perceived cognitive impairment in a group of breast cancer patients in semi-rural South Africa.Setting: The patients were recruited from an outpatient oncology clinic at a semi-rural, tertiary academic hospital in Gauteng, South Africa.Methods: In a randomised, quantitative, time-based series study, 30 female patients aged 21–60 years (mean age = 50 years) diagnosed with stages II and III breast cancer on CMF (cyclophosphamide, methotrexate, fluorouracil) (n = 10) and FAC (fluorouracil, adriamycin, cyclophosphamide) (n = 20) chemotherapy regimens, completed the self-reported Functional Assessment of Cancer Therapy-Cognition (Fact-Cog) test as a measure of subjective cognitive functioning at three points during the course of treatment (T0, T1, T2).Results: The results of the paired sample t-tests showed the scores on the Fact-Cog test confirmed significant cognitive decline for both treatment groups from baseline (T0) to completion (T2) of chemotherapy; CMF group, t (9) = 2.91, p = 0.017 and the FAC group t (19) = 4.66, p 0.001.Conclusion: This study confirms that self-reported subjective cognitive impairment is common in breast cancer patients who received chemotherapy in a sample of South African patients. The results have implications for the overall care of cancer patients.Contribution: The context-based knowledge engendered by the current study is expected to augment the continuum of care for breast cancer patients.

Liver Blood Flow as a Major Determinant of the Clearance of Recombinant Human Tissue-Type Plasminogen Activator

1992 ◽  
Vol 67 (01) ◽  
pp. 083-087 ◽  
Author(s):  
A de Boer ◽  
C Kluft ◽  
J M Kroon ◽  
F J Kasper ◽  
H C Schoemaker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Rat Liver ◽  
Healthy Subjects ◽  
Liver Blood Flow ◽  
Major Determinant ◽  
Tissue Type ◽  
Perfused Rat Liver ◽  
Liver Model ◽  
Type Plasminogen Activator ◽  
Proportional Change

SummaryThe influence of changes in liver blood flow on the clearance of rt-PA was studied both in healthy subjects and in a perfused rat liver model. Liver blood flow in healthy subjects was documented indirectly by the clearance of indocyanine green (ICG). Exercise reduced liver blood flow on average by 57% with a 95% confidence interval (95% Cl) ranging from 51% to 62% (n = 5) and increased plasma levels of rt-PA activity (after an i. v. infusion of 18 mg of rt-PA over 120 min) by 119% (95% Cl, 58% - 203%) and rt-PA antigen by 91% (95% Cl, 30% - 140%). In the perfused rat liver model it was shown that halving or doubling of the physiological flow rate of a perfusate, containing rt-PA caused a proportional change in the clearance of rt-PA, while the extraction of rt-PA by the liver remained similar. In conclusion, liver blood flow is a major determinant of the clearance of rt-PA. This may have important implications for dosage of rt-PA in patients with myocardial infarction.

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