Faculty Opinions recommendation of Clinical and biological effects of long-term lithium treatment in older adults with amnestic mild cognitive impairment: randomised clinical trial.

2019 ◽  
Author(s):  
Craig Ritchie ◽  
Abel Koshy
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Biological Effects ◽  
Lithium Treatment ◽  
Randomised Clinical Trial ◽  
Amnestic Mild Cognitive Impairment

Clinical and biological effects of long-term lithium treatment in older adults with amnestic mild cognitive impairment: randomised clinical trial

2019 ◽  
Vol 215 (5) ◽  
pp. 668-674 ◽  
Author(s):  
Orestes V. Forlenza ◽  
Márcia Radanovic ◽  
Leda L. Talib ◽  
Wagner F. Gattaz
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lithium Treatment ◽  
Functional Decline ◽  
Amnestic Mild Cognitive Impairment ◽  
Community Dwelling

BackgroundExperimental studies indicate that lithium may facilitate neurotrophic/protective responses in the brain. Epidemiological and imaging studies in bipolar disorder, in addition to a few trials in Alzheimer's disease support the clinical translation of these findings. Nonetheless, there is limited controlled data about potential use of lithium to treat or prevent dementia.AimsTo determine the benefits of lithium treatment in patients with amnestic mild cognitive impairment (MCI), a clinical condition associated with high risk for Alzheimer's disease.MethodA total of 61 community-dwelling, physically healthy, older adults with MCI were randomised to receive lithium or placebo (1:1) for 2 years (double-blind phase), and followed-up for an additional 24 months (single-blinded phase) (trial registration at clinicaltrials.gov: NCT01055392). Lithium carbonate was prescribed to yield subtherapeutic concentrations (0.25–0.5 mEq/L). Primary outcome variables were the cognitive (Alzheimer's Disease Assessment Scale – cognitive subscale) and functional (Clinical Dementia Rating – Sum of Boxes) parameters obtained at baseline and after 12 and 24 months. Secondary outcomes were neuropsychological test scores; cerebrospinal fluid (CSF) concentrations of Alzheimer's disease-related biomarkers determined at 0, 12 and 36 months; conversion rate from MCI to dementia (0–48 months).ResultsParticipants in the placebo group displayed cognitive and functional decline, whereas lithium-treated patients remained stable over 2 years. Lithium treatment was associated with better performance on memory and attention tests after 24 months, and with a significant increase in CSF amyloid-beta peptide (Aβ1−42) after 36 months.ConclusionsLong-term lithium attenuates cognitive and functional decline in amnestic MCI, and modifies Alzheimer's disease-related CSF biomarkers. The present data reinforces the disease-modifying properties of lithium in the MCI–Alzheimer's disease continuum.Declaration of interestNone.

scholarly journals The PACE Study: A randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI)

Trials ◽  
2009 ◽  
Vol 10 (1) ◽  
Author(s):  
Mandy R Vidovich ◽  
Nicola T Lautenschlager ◽  
Leon Flicker ◽  
Linda Clare ◽  
Osvaldo P Almeida
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Activity ◽  
Randomised Clinical Trial

scholarly journals Disease-modifying properties of long-term lithium treatment for amnestic mild cognitive impairment: randomised controlled trial

2011 ◽  
Vol 198 (5) ◽  
pp. 351-356 ◽  
Author(s):  
Orestes V. Forlenza ◽  
Breno S. Diniz ◽  
Márcia Radanovic ◽  
Franklin S. Santos ◽  
Leda L. Talib ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lithium Treatment ◽  
Amnestic Mild Cognitive Impairment ◽  
Disease Assessment ◽  
Short Term Treatment ◽  
Disease Modifying

BackgroundTwo recent clinical studies support the feasibility of trials to evaluate the disease-modifying properties of lithium in Alzheimer's disease, although no benefits were obtained from short-term treatment.AimsTo evaluate the effect of long-term lithium treatment on cognitive and biological outcomes in people with amnestic mild cognitive impairment (aMCI).MethodForty-five participants with aMCI were randomised to receive lithium (0.25–0.5 mmol/l) (n = 24) or placebo (n = 21) in a 12-month, double-blind trial. Primary outcome measures were the modification of cognitive and functional test scores, and concentrations of cerebrospinal fluid (CSF) biomarkers (amyloid-beta peptide (Aβ42), total tau (T-tau), phosphorylated-tau) (P-tau). Trial registration: NCT01055392.ResultsLithium treatment was associated with a significant decrease in CSF concentrations of P-tau (P = 0.03) and better perform-ance on the cognitive subscale of the Alzheimer's Disease Assessment Scale and in attention tasks. Overall tolerability of lithium was good and the adherence rate was 91%.ConclusionsThe present data support the notion that lithium has disease-modifying properties with potential clinical implications in the prevention of Alzheimer's disease.

scholarly journals Prevalence, Cognitive Characteristics and Influence Factors of Amnestic Mild Cognitive Impairment among Community-dwelling Older Adults in Chengdu, China

2021 ◽  
Author(s):  
Peiyuan Qiu ◽  
Yan Cai ◽  
Yangyang Wang ◽  
Shiyi Liao ◽  
Yunbo Nie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Multiple Logistic Regression Analysis ◽  
Amnestic Mild Cognitive Impairment ◽  
Multiple Logistic Regression ◽  
Delayed Recall ◽  
Cognitive Characteristics

Abstract Background: Dementia is a global public health priority. Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia. And amnestic MCI (aMCI) is proved to have a higher probability to develop into AD comparing to other type of MCI. Yet a few studies have focused on prevalence of aMCI in China. This study aims to explore the prevalence of amnestic mild cognitive impairment (aMCI), cognitive characteristics of aMCI, and associated risk factors for aMCI.Methods: A cross-sectional study was conducted in the communities of Chengdu, China. Participants were 368 older adults aged 60 years and over. Participants completed various neuropsychological assessments, including the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), Auditory Verbal Learning Test (AVLT), Wechsler’s Logical Memory Task (LMT), Boston Naming Test (BNT) and Trail Making Test Part A (TMT-A). Social information was collected by standard questionnaire. Multiple logistic regression analysis was utilized to screen for the risk and protective factors of aMCI.Results: Data included 309 subjects with normal cognitive function and 59 with aMCI. The prevalence of aMCI was 16.0%.The average age of participants was 69.06±7.30 years, with 56.0% being females. After controlling for age, gender and education, the Spearman partial correlation coefficient between diverse cognitive assessments and aMCI ranged from -0.52 for the long-term delayed recall scores in AVLT to 0.19 for the time-usage scores in TMT-A, and results revealed that all domains except naming scores (after semantic cue of BNT) and error quantity (in TMT-A) showed statistically significant associations with aMCI. And the results of multiple logistic regression analysis indicated that older age (OR=1.044, 95%CI: 1.002~1.087, p=0.042), lower educational level, and diabetes (OR=2.450, 95%CI: 1.246~4.818, p=0.009) were risk factors of aMCI.Conclusions: Participants with aMCI showed lower cognitive function in memory, language and executive domains, especially in long-term delayed recall. The participants who were older, had less education, or with diabetes had higher risk of suffering from aMCI. These results may help clinical practitioners design and conduct targeted cognitive training and chronic disease management for the elderly, aiming to prevent and delay development of Alzheimer’s dementia.

scholarly journals Five-Year Change in Body Mass Index Predicts Conversion to Mild Cognitive Impairment or Dementia Only in APOE ɛ4 Allele Carriers

2021 ◽  
pp. 1-11
Author(s):  
Kylie R. Kadey ◽  
John L. Woodard ◽  
Allison C. Moll ◽  
Kristy A. Nielson ◽  
J. Carson Smith ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Body Mass ◽  
Carrier Status ◽  
Healthy Older Adults ◽  
E4 Allele ◽  
Lifestyle Risk

Background: Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. Objective: The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. Methods: The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer’s Coordinating Center (NACC) database. Results: After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p <  0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96–1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96–1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78–1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53–0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57–0.94). Conclusion: A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.

Neurocognitive Plasticity Is Associated with Cardiorespiratory Fitness Following Physical Exercise in Older Adults with Amnestic Mild Cognitive Impairment

2021 ◽  
pp. 1-22
Author(s):  
Galit Yogev-Seligmann ◽  
Tamir Eisenstein ◽  
Elissa Ash ◽  
Nir Giladi ◽  
Haggai Sharon ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
Neuropsychological Tests ◽  
Aerobic Training ◽  
Amnestic Mild Cognitive Impairment ◽  
Control Group ◽  
Memory Encoding

Background: Aerobic training has been shown to promote structural and functional neurocognitive plasticity in cognitively intact older adults. However, little is known about the neuroplastic potential of aerobic exercise in individuals at risk of Alzheimer’s disease (AD) and dementia. Objective: We aimed to explore the effect of aerobic exercise intervention and cardiorespiratory fitness improvement on brain and cognitive functions in older adults with amnestic mild cognitive impairment (aMCI). Methods: 27 participants with aMCI were randomized to either aerobic training (n = 13) or balance and toning (BAT) control group (n = 14) for a 16-week intervention. Pre- and post-assessments included functional MRI experiments of brain activation during associative memory encoding and neural synchronization during complex information processing, cognitive evaluation using neuropsychological tests, and cardiorespiratory fitness assessment. Results: The aerobic group demonstrated increased frontal activity during memory encoding and increased neural synchronization in higher-order cognitive regions such as the frontal cortex and temporo-parietal junction (TPJ) following the intervention. In contrast, the BAT control group demonstrated decreased brain activity during memory encoding, primarily in occipital, temporal, and parietal areas. Increases in cardiorespiratory fitness were associated with increases in brain activation in both the left inferior frontal and precentral gyri. Furthermore, changes in cardiorespiratory fitness were also correlated with changes in performance on several neuropsychological tests. Conclusion: Aerobic exercise training may result in functional plasticity of high-order cognitive areas, especially, frontal regions, among older adults at risk of AD and dementia. Furthermore, cardiorespiratory fitness may be an important mediating factor of the observed changes in neurocognitive functions.

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