scholarly journals Targeted Nutritional Intervention for Patients with Mild Cognitive Impairment: The Cognitive impAiRmEnt Study (CARES) Trial 1

2020 ◽  
Vol 10 (2) ◽  
pp. 43 ◽  
Author(s):  
Rebecca Power ◽  
John Nolan ◽  
Alfonso Prado-Cabrero ◽  
Robert Coen ◽  
Warren Roche ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Vitamin E ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Synergistic Effects ◽  
Small Sample Size ◽  
Nutritional Intervention ◽  
Small Sample ◽  
Global Cognition

Omega-3 fatty acids (ω-3FAs), carotenoids, and vitamin E are important constituents of a healthy diet. While they are present in brain tissue, studies have shown that these key nutrients are depleted in individuals with mild cognitive impairment (MCI) in comparison to cognitively healthy individuals. Therefore, it is likely that these individuals will benefit from targeted nutritional intervention, given that poor nutrition is one of the many modifiable risk factors for MCI. Evidence to date suggests that these nutritional compounds can work independently to optimize the neurocognitive environment, primarily due to their antioxidant and anti-inflammatory properties. To date, however, no interventional studies have examined the potential synergistic effects of a combination of ω-3FAs, carotenoids and vitamin E on the cognitive function of patients with MCI. Individuals with clinically confirmed MCI consumed an ω-3FA plus carotenoid plus vitamin E formulation or placebo for 12 months. Cognitive performance was determined from tasks that assessed global cognition and episodic memory. Ω-3FAs, carotenoids, and vitamin E were measured in blood. Carotenoid concentrations were also measured in tissue (skin and retina). Individuals consuming the active intervention (n = 6; median [IQR] age 73.5 [69.5–80.5] years; 50% female) exhibited statistically significant improvements (p < 0.05, for all) in tissue carotenoid concentrations, and carotenoid and ω-3FA concentrations in blood. Trends in improvements in episodic memory and global cognition were also observed in this group. In contrast, the placebo group (n = 7; median [IQR] 72 (69.5–75.5) years; 89% female) remained unchanged or worsened for all measurements (p > 0.05). Despite a small sample size, this exploratory study is the first of its kind to identify trends in improved cognitive performance in individuals with MCI following supplementation with ω-3FAs, carotenoids, and vitamin E.

Joint effects of gray matter atrophy and altered functional connectivity on cognitive deficits in amnestic mild cognitive impairment patients

2014 ◽  
Vol 45 (9) ◽  
pp. 1799-1810 ◽  
Author(s):  
C. Xie ◽  
F. Bai ◽  
B. Yuan ◽  
H. Yu ◽  
Y. Shi ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Connectivity ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Gray Matter ◽  
Cognitive Deficits ◽  
Amnestic Mild Cognitive Impairment ◽  
Multivariate Linear Regression Analysis

BackgroundGray matter (GM) atrophy and disrupted intrinsic functional connectivity (IFC) are often present in patients with amnestic mild cognitive impairment (aMCI), which shows high risk of developing into Alzheimer's disease. Little is known, however, about the relationship between GM atrophy and altered IFC, and whether they are related to cognitive decline.MethodA total of 30 aMCI and 26 cognitively normal (CN) subjects were recruited for this study. Optimized voxel-based morphometric and resting-state functional connectivity magnetic resonance imaging approaches were performed to measure the GM volumes (GMVs) and atrophy-related IFC, respectively. Multivariate linear regression analysis was used to examine the effects of GM atrophy and IFC on cognitive performance across subjects, after controlling for the effects of age, education, gender and group.ResultsCompared with CN subjects, aMCI subjects showed significantly reduced GMVs and decreased IFC in the frontal-parietal and medial temporal lobe systems. Multivariate regression analysis further demonstrated that the GMVs and decreased IFC simultaneously affected the cognitive function. Specifically, GMVs were positively correlated with cognitive performances, including global cognition and episodic memory, and showed a strong trend in correlation between GMVs and non-episodic memory, whilst IFC was positively correlated with the above three cognitive measures, across all subjects. In addition, significant correlation was found between GMVs and altered IFC strength across all subjects.ConclusionsOur findings demonstrated that GMVs and IFC jointly contribute to cognitive performance, and combining quantitative information about GMVs and the strength of functional connectivity may serve as an indicator of cognitive deficits in non-demented elderly.

Association of the LRP1 gene and cognitive performance with amnestic mild cognitive impairment in elderly Chinese

2009 ◽  
Vol 21 (6) ◽  
pp. 1072-1080 ◽  
Author(s):  
Yong M. Shi ◽  
Hong Zhou ◽  
Zhi J. Zhang ◽  
Hui Yu ◽  
Feng Bai ◽  
...  
Keyword(s):  
Genetic Variation ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Poor Performance ◽  
Amnestic Mild Cognitive Impairment ◽  
Healthy Controls

ABSTRACTBackground: The genetic region coding for low-density lipoprotein receptor-related protein1 (LRP1) is considered an intriguing susceptibility locus for Alzheimer's disease (AD). Amnestic mild cognitive impairment (aMCI) is characterized by episodic memory impairment and represents the prodromal stage of AD. Our aim in this study is to investigate the relationship between LRP1 genetic variation and aMCI, and the influence of LRP1 on cognitive performance.Methods: We performed a case-control association study analyzing five polymorphisms in LRP1 gene by TaqMan Assays-on-Demand SNP Genotyping. All samples were derived from Chinese subjects (109 cases, 104 healthy controls) and assessed using multi-dimension neuropsychological instruments.Results: We identified haplotypes within the region containing the LRP1 gene. Of these, haplotype TAA (T: rs1800194; A: rs11837145; A: rs10876967) was significantly associated with aMCI, being over-represented in aMCI versus healthy controls. Haplotype TAA was associated with poor performance on episodic memory in all subjects.Conclusions: This study confirms the association between genetic variants in LRP1 and aMCI. Moreover, we have identified a relationship between LRP1 genetic variation and specific aspects of neurocognitive function. Our convergent results suggest that LRP1 plays an important role in cognitive function and possibly in the pathogenesis of aMCI.

scholarly journals Association between tea consumption and cognitive function in cognitively healthy older adults and older adults with mild cognitive impairment

2021 ◽  
Vol 34 (4) ◽  
pp. e100512
Author(s):  
Hua Xu ◽  
Alexandra J Fiocco ◽  
Xiaohua Liu ◽  
Tao Wang ◽  
Guanjun Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Tea Consumption ◽  
Healthy Older Adults ◽  
Global Cognitive Function

BackgroundProspective studies suggest that tea consumption may decrease the risk for cognitive impairment in late life. However, little research has examined the association between tea consumption and cognitive performance across multiple domains. In addition, no research has examined the benefit of tea consumption on cognitive performance among older adults with existing impairment.AimsThe current study examined the association between tea consumption and performance on tasks of global cognitive function, episodic memory and executive function in cognitively healthy (CH) older adults and older adults with mild cognitive impairment (MCI).MethodsThe analytical sample included 1849 community-dwelling older adults from the Shanghai Brain Aging Study (65.6% female, mean age of 69.50 (8.02) years). Following ascertainment of cognitive function, 816 were categorised as MCI. In addition to completion of a demographics questionnaire, participants reported their tea consumption and completed a battery of tests to measure global cognitive function, episodic memory and working memory.ResultsIndependent analyses of covariance revealed a significant association between tea consumption and measures of episodic memory; however, these associations were restricted to CH older adults but not older adults with MCI. Tea consumption was not associated with working memory performance.ConclusionsThe current study suggests that the benefit of tea consumption is restricted to cognitively healthy older adults and does not extend to older adults with MCI.

scholarly journals Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

2021 ◽  
Vol 12 ◽  
Author(s):  
Yangfan Xu ◽  
Lingrong Yi ◽  
Yangyang Lin ◽  
Suiying Peng ◽  
Weiming Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Sample Size ◽  
Small Sample Size ◽  
Small Sample ◽  
Chinese Version ◽  
Cognitive Screening ◽  
Post Stroke ◽  
Normal Cognition

Background: Screening for post-stroke cognitive impairment (PSCI) is necessary because stroke increases the incidence of and accelerates premorbid cognitive decline. The Quick Mild Cognitive Impairment (Qmci) screen is a short, reliable and accurate cognitive screening instrument but is not yet validated in PSCI. We compared the diagnostic accuracy of a Chinese version of the Qmci screen (Qmci-CN) compared with the widely-used Chinese versions of the Montreal Cognitive Assessment (MoCA-CN) and Mini-Mental State Examination (MMSE-CN).Methods: We recruited 34 patients who had recovered from a stroke in rehabilitation unit clinics in 2 university hospitals in China: 11 with post-stroke dementia (PSD), 15 with post-stroke cognitive impairment no dementia (PSCIND), and 8 with normal cognition (NC). Classification was made based on clinician assessment supported by a neuropsychological battery, independent of the screening test scores. The Qmci-CN, MoCA-CN, and MMSE-CN screens were administered randomly by a trained rater, blind to the diagnosis.Results: The mean age of the sample was 63 ± 13 years and 61.8% were male. The Qmci-CN had statistically similar diagnostic accuracy in differentiating PSD from NC, an area under the curve (AUC) of 0.94 compared to 0.99 for the MoCA-CN (p = 0.237) and 0.99 for the MMSE-CN (p = 0.293). The Qmci-CN (AUC 0.91), MoCA-CN (AUC 0.94), and MMSE-CN (AUC 0.79) also had statistically similar accuracy in separating PSD from PSCIND. The MoCA-CN more accurately distinguished between PSCIND and normal cognition than the Qmci-CN (p = 0.015). Compared to the MoCA-CN, the administration times of the Qmci-CN (329s vs. 611s, respectively, p &lt; 0.0001) and MMSE-CN (280 vs. 611s, respectively, p &lt; 0.0001) were significantly shorter.Conclusion: The Qmci-CN is accurate in identifying PSD and separating PSD from PSCIND in patients post-stroke following rehabilitation and is comparable to the widely-used MoCA-CN, albeit with a significantly shorter administration time. The Qmci-CN had relatively poor accuracy in identifying PSCIND from NC and hence may lack accuracy for certain subgroups. However, given the small sample size, the study is under-powered to show superiority of one instrument over another. Further study is needed to confirm these findings in a larger sample size and in other settings (countries and languages).

scholarly journals Cognition in a multiple system atrophy series of cases from Argentina

2014 ◽  
Vol 72 (10) ◽  
pp. 773-776 ◽  
Author(s):  
Emilia Gatto ◽  
Ignacio Demey ◽  
Ana Sanguinetti ◽  
Virginia Parisi ◽  
José Luis Etcheverry ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Informed Consent ◽  
Episodic Memory ◽  
Multiple System Atrophy ◽  
Small Sample Size ◽  
Small Sample ◽  
Cognitive Domain ◽  
Cognitive Tests ◽  
Cognitive Profiles ◽  
Visuospatial Abilities

Cognitive dysfunction may occur in 17-40% of patients with multiple system atrophy (MSA). It has been suggested a milder cognitive impairment in cerebellar (MSA-C) than in parkinsonian variant (MSA-P). However, differences in cognitive profiles remain under discussion. Objective To evaluate cognitive features in a series of patients with “probable MSA” from Argentina. Method After informed consent was obtained, an extensive cognitive tests battery was administered. Nine patients (6 MSA-P and 3 MSA-C) composed the sample. Results Depression was detected in 43% of patients. Seven patients showed at least one cognitive domain impairment. Temporospatial orientation, visuospatial abilities, executive and attentional functions, episodic memory and language were compromised in MSA-P, while MSA-C dysfunction was restricted to attentional and executive domains. Conclusion Despite the small sample size, our findings could suggest a more widespread cognitive impairment in MSA-P than MSA-C.

scholarly journals Mild cognitive impairment: when nutrition helps brain energy rescue—a report from the EuGMS 2020 Congress

2021 ◽  
Author(s):  
Stephen C. Cunnane ◽  
Cornel C. Sieber ◽  
Russell H. Swerdlow ◽  
Alfonso J. Cruz-Jentoft
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Alternative Energy ◽  
Nutritional Intervention ◽  
Older Individuals ◽  
Nutritional Interventions ◽  
The Brain ◽  
Brain Energy

Abstract Background Mild cognitive impairment (MCI) is characterized by a decline in cognition and mainly affects older individuals above the age of 60. The global incidence of MCI varies, but it is often underdiagnosed and untreated. There is a distinct lack of approved pharmacologic options to treat MCI. There is, however, evidence to support the efficacy of nutritional interventions, such as ketogenic supplements/diets, which offer ketones as an alternative energy source to brain cells. This article explores the effect of ketones on metabolic activity in the brain and the mechanisms by which ketogenic medium-chain triglycerides (kMCTs) induce ketosis in patients with MCI. Key takeaways This article reviews the effect of ketogenic supplements/diets on brain metabolism, including evidence supporting the efficacy of ketones as an efficient fuel for the brain. It discusses the use of oral nutritional ketogenic supplements, with particular reference to the 6-month randomized controlled BENEFIC trial, which showed that consumption of a kMCT drink, BrainXpert Energy Complex, improved cognitive performance in individuals with MCI compared with placebo. Conclusion While there is a need for more long-term studies, results from the BENEFIC trial revealed the benefits of a brain-specific ketogenic supplement, as a nutritional intervention, on cognitive performance in individuals with MCI.

scholarly journals Using historical data to facilitate clinical prevention trials in Alzheimer disease? An analysis of longitudinal MCI (mild cognitive impairment) data sets

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Manfred Berres ◽  
Andreas U. Monsch ◽  
René Spiegel
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Placebo Treatment ◽  
Drug Trial ◽  
The Other ◽  
Data Sets ◽  
Control Groups ◽  
Community Needs ◽  
Clinical Prevention

Abstract Background The Placebo Group Simulation Approach (PGSA) aims at partially replacing randomized placebo-controlled trials (RPCTs), making use of data from historical control groups in order to decrease the needed number of study participants exposed to lengthy placebo treatment. PGSA algorithms to create virtual control groups were originally derived from mild cognitive impairment (MCI) data of the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. To produce more generalizable algorithms, we aimed to compile five different MCI databases in a heuristic manner to create a “standard control algorithm” for use in future clinical trials. Methods We compared data from two North American cohort studies (n=395 and 4328, respectively), one company-sponsored international clinical drug trial (n=831) and two convenience patient samples, one from Germany (n=726), and one from Switzerland (n=1558). Results Despite differences between the five MCI samples regarding inclusion and exclusion criteria, their baseline demographic and cognitive performance data varied less than expected. However, the five samples differed markedly with regard to their subsequent cognitive performance and clinical development: (1) MCI patients from the drug trial did not deteriorate on verbal fluency over 3 years, whereas patients in the other samples did; (2) relatively few patients from the drug trial progressed from MCI to dementia (about 10% after 4 years), in contrast to the other four samples with progression rates over 30%. Conclusion Conventional MCI criteria were insufficient to allow for the creation of well-defined and internationally comparable samples of MCI patients. More recently published criteria for MCI or “MCI due to AD” are unlikely to remedy this situation. The Alzheimer scientific community needs to agree on a standard set of neuropsychological tests including appropriate selection criteria to make MCI a scientifically more useful concept. Patient data from different sources would then be comparable, and the scientific merits of algorithm-based study designs such as the PGSA could be properly assessed.

scholarly journals VAMP-2 is a surrogate cerebrospinal fluid marker of Alzheimer-related cognitive impairment in adults with Down syndrome

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Alberto Lleó ◽  
Maria Carmona-Iragui ◽  
Laura Videla ◽  
Susana Fernández ◽  
Bessy Benejam ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Down Syndrome ◽  
Cognitive Impairment ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Synaptic Proteins ◽  
Selected Reaction Monitoring ◽  
Synaptic Protein ◽  
Csf Levels ◽  
Syntaxin 1B

Abstract Background There is an urgent need for objective markers of Alzheimer’s disease (AD)-related cognitive impairment in people with Down syndrome (DS) to improve diagnosis, monitor disease progression, and assess response to disease-modifying therapies. Previously, GluA4 and neuronal pentraxin 2 (NPTX2) showed limited potential as cerebrospinal fluid (CSF) markers of cognitive impairment in adults with DS. Here, we compare the CSF profile of a panel of synaptic proteins (Calsyntenin-1, Neuroligin-2, Neurexin-2A, Neurexin-3A, Syntaxin-1B, Thy-1, VAMP-2) to that of NPTX2 and GluA4 in a large cohort of subjects with DS across the preclinical and clinical AD continuum and explore their correlation with cognitive impairment. Methods We quantified the synaptic panel proteins by selected reaction monitoring in CSF from 20 non-trisomic cognitively normal controls (mean age 44) and 80 adults with DS grouped according to clinical AD diagnosis (asymptomatic, prodromal AD or AD dementia). We used regression analyses to determine CSF changes across the AD continuum and explored correlations with age, global cognitive performance (CAMCOG), episodic memory (modified cued-recall test; mCRT) and CSF biomarkers, CSF Aβ42:40 ratio, CSF Aβ1-42, CSF p-tau, and CSF NFL. P values were adjusted for multiple testing. Results In adults with DS, VAMP-2 was the only synaptic protein to correlate with episodic memory (delayed recall adj.p = .04) and age (adj.p = .0008) and was the best correlate of CSF Aβ42:40 (adj.p = .0001), p-tau (adj.p < .0001), and NFL (adj.p < .0001). Compared to controls, mean VAMP-2 levels were lower in asymptomatic adults with DS only (adj.p = .02). CSF levels of Neurexin-3A, Thy-1, Neurexin-2A, Calysntenin-1, Neuroligin-2, GluA4, and Syntaxin-1B all strongly correlated with NPTX2 (p < .0001), which was the only synaptic protein to show reduced CSF levels in DS at all AD stages compared to controls (adj.p < .002). Conclusion These data show proof-of-concept for CSF VAMP-2 as a potential marker of synapse degeneration that correlates with CSF AD and axonal degeneration markers and cognitive performance.

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