Cognitive Impairment
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2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Qian Wang ◽  
Kai Wang ◽  
Yihong Ma ◽  
Simin Li ◽  
Yuzhen Xu

Objective. Galectin-3, an inflammatory mediator derived from microglia, participates in the pathophysiological process of various neurological diseases. However, the relationship between galectin-3 and poststroke cognitive impairment (PSCI) remains ambiguous. This research purposed to prove whether serum galectin-3 can predict PSCI. Methods. In the end, an aggregate of 416 patients with the first acute ischemic stroke (AIS) were continuously and prospectively enrolled in the study. Upon admission, the baseline data of AIS patients were collected, and their serum galectin-3 levels were measured. Three months after the stroke, the Montreal Cognitive Scale (MoCA) was utilized to measure the cognitive function of AIS patients, and PSCI was defined as a MoCA score less than 26 points. Results. Premised on the MoCA scores, patients were categorized into PSCI cohort and non-PSCI cohort. The two AIS patient cohorts did not exhibit any statistical difference in their baseline characteristics ( p > 0.05 ). However, the serum galectin-3 level of AIS patients in the PSCI cohort was considerably elevated ( p < 0.001 ). Pearson correlation analysis illustrated that serum galectin-3 level was negatively linked to MoCA score ( r = − 0.396 , p < 0.05 ). The findings from the receiver-operating curve (ROC) illustrated that the sensitivity of serum galectin-3 as a possible biomarker for diagnosing PSCI was 66%, and the specificity was 94%. The cut-off value of serum galectin-3 to diagnose PSCI is 6.3 ng/mL ( OR = 5.49 , p < 0.001 ). Upon controlling for different variables, serum galectin-3 level remained to be an independent predictor of PSCI ( p < 0.001 ). Conclusions. Elevated serum galectin-3 levels are linked to a higher risk of PSCI. Serum galectin-3 could be a prospective biomarker for predicting PSCI.


2021 ◽  
Vol 12 ◽  
Author(s):  
Kirsty Crowe ◽  
Terence J. Quinn ◽  
Patrick B. Mark ◽  
Mark D. Findlay

Cognitive impairment is independently associated with kidney disease and increases in prevalence with declining kidney function. At the stage where kidney replacement therapy is required, with dialysis or transplantation, cognitive impairment is up to three times more common, and can present at a younger age. This is not a new phenomenon. The cognitive interactions of kidney disease are long recognized from historical accounts of uremic encephalopathy and so-called “dialysis dementia” to the more recent recognition of cognitive impairment in those undergoing kidney replacement therapy (KRT). The understanding of cognitive impairment as an extra-renal complication of kidney failure and effect of its treatments is a rapidly developing area of renal medicine. Multiple proposed mechanisms contribute to this burden. Advanced vascular aging, significant multi-morbidity, mood disorders, and sleep dysregulation are common in addition to the disease-specific effects of uremic toxins, chronic inflammation, and the effect of dialysis itself. The impact of cognitive impairment on people living with kidney disease is vast ranging from increased hospitalization and mortality to decreased quality of life and altered decision making. Assessment of cognition in patients attending for renal care could have benefits. However, in the context of a busy clinical service, a pragmatic approach to assessing cognitive function is necessary and requires consideration of the purpose of testing and resources available. Limited evidence exists to support treatments to mitigate the degree of cognitive impairment observed, but promising interventions include physical or cognitive exercise, alteration to the dialysis treatment and kidney transplantation. In this review we present the history of cognitive impairment in those with kidney failure, and the current understanding of the mechanisms, effects, and implications of impaired cognition. We provide a practical approach to clinical assessment and discuss evidence-supported treatments and future directions in this ever-expanding area which is pivotal to our patients' quality and quantity of life.


2021 ◽  
Vol 12 ◽  
Author(s):  
Shaowei Zhang ◽  
Qi Qiu ◽  
Shixing Qian ◽  
Xiang Lin ◽  
Feng Yan ◽  
...  

Background: The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most commonly used tools for cognitive impairment screening. The present study aimed to investigate the ability of the MOCA and MMSE to differentiate between cognitively normal elderly individuals, MCI patients and dementia patients at different ages and education levels and to establish the optimal cutoff scores of the MoCA and MMSE for MCI and dementia in the Chinese elderly.Methods: A total of 2,954 Chinese elderly individuals, including 1,746 normal controls, 599 MCI patients and 249 dementia patients, were consecutively recruited in the study. The optimal cutoffs for MoCA and MMSE were determined using receiver operating characteristic (ROC) analysis among the different age and education levels in the three groups. Furthermore, comparison of ROC curves were made to evaluate the performances of the two tests.Results: The area under the curve(AUC) of the MoCA (0.82) for detecting MCI was significantly higher than that of the MMSE (0.75) (P &lt; 0.001). When the sample was divided according to age and education level, the AUC of the MoCA (0.84) was higher than those of the MMSE (0.71) for MCI (P &lt; 0.001) in the younger and more highly-educated groups. The optimal cutoff scores of the MoCA for the groups aged ≤ 75 years old and education ≤ 6 years, aged &gt; 75 years old and education ≤ 6 years, aged ≤ 75 years old and education &gt; 6 years, aged &gt; 75 years old and education &gt; 6 years in screening for MCI were identified as 19.5, 15.5, 24.5 and 24.5, respectively, and the optimal cutoff scores for dementia were 18.5, 10.5, 18.5 and 20.5, respectively. For MMSE in the above four groups, the cutoff scores to detect MCI were 26.5, 22.5, 28.5 and 26.5, respectively, and the optimal cutoff scores for dementia were 23.5, 19.5, 23.5 and 23.5, respectively.Conclusion: Compared to MMSE, the MoCA is more suitable for discriminating MCI in younger and more highly educated elderly Chinese individuals. However, the MMSE has advantage over MoCA in screening MCI in individuals with lower education levels and the older groups of Chinese elderly.


Author(s):  
Александр Викторович Иванов ◽  
Татьяна Игоревна Субботина ◽  
Антон Александрович Титов ◽  
Юрий Юрьевич Блинков ◽  
Надежда Александровна Поздеева ◽  
...  

У пациентов пожилого возраста часто наблюдается сочетание полиморбидной сердечно-сосудистой патологии с офтальмопатологией и, в частности, с первичной открытоугольной глаукомой (ПОУГ). Однако гериатрический статус таких пациентов изучен недостаточно. Цель исследования: изучение особенностей гериатрического статуса пожилых больных с сочетанной сердечно-сосудистой и офтальмопатологической патологией. Обследовано в клинических условиях 58 пациентов с инфарктом миокарда, артериальной гипертензией и первичной открытоугольной глаукомой. Установлено, что развитие офтальмопатологии в виде первичной открытоугольной глаукомы в сочетании с сердечно-сосудистой патологий сопровождается формированием и прогрессированием гериатрического континуума пожилых пациентов. Уровень личностной тревожности при первичной гериатрической оценке у анализируемых больных составлял 42,9±1,1 балла и соответствовал умеренному уровню тревожности. Однако после хирургического лечения он незначительно понизился до 40,6±1,2 балла (Р±0,05). Аналогичные изменения характерны и для ситуативной тревожности, которая при первичной гериатрической оценке была умеренной (40,8±1,2 балла) и не претерпела существенных изменений после выполнения антиглаукомного хирургического вмешательства, составив 40,3±1,4 балла (Р±0,05). Оценка когнитивного статуса пациентов пожилого возраста с первичной открытоугольной глаукомой в до и после операционном периодах показывает недостоверное снижение когнитивного дефицита. Уровень когнитивных нарушений по шкале CFS у пациентов в предоперационном периоде составлял 18,22±0,4 балла (легкие когнитивные нарушения). Следовательно, полиморбидная патология изменяет гериатрический статус пациентов, что следует учитывать в гериатрической практике In elderly patients, a combination of polymorbid cardiovascular pathology with ophthalmopathology and, in particular, with primary open-angle glaucoma (POAG) is often observed. However, the geriatric status of such patients has not been sufficiently studied. Objective: to study the features of the geriatric status of elderly patients with combined cardiovascular and ophthalmopathological pathology. A total of 58 patients with myocardial infarction, arterial hypertension, and primary open-angle glaucoma were examined in clinical settings. It was established that the development of ophthalmopathology in the form of primary open-angle glaucoma in combination with cardiovascular pathology is accompanied by the formation and progression of the geriatric continuum of elderly patients. The level of personal anxiety in the primary geriatric assessment in the analyzed patients was 42.9±1.1 points and corresponded to a moderate level of anxiety. However, after surgical treatment, it decreased slightly to 40.6±1.2 points (P±0.05). Similar changes are also characteristic of situational anxiety, which was moderate (40.8±1.2 points) in the initial geriatric assessment and did not undergo significant changes after performing anti-glaucoma surgery, amounting to 40.3±1.4 points (P±0.05). Assessment of the cognitive status of elderly patients with primary open-angle glaucoma in the pre-and postoperative periods shows an unreliable decrease in cognitive deficits. The level of cognitive impairment on the CFS scale in patients in the preoperative period was 18.22±0.4 points (mild cognitive impairment). Consequently, polymorbid pathology changes the geriatric status of patients, which should be taken into account in geriatric practice


2021 ◽  
Author(s):  
Lucas Alexis Ronat ◽  
Alexndru Hanganu

The impact of neuropsychiatric symptoms (NPS) on cognitive performance has been extensively reported, and this impact was better defined in the aging population. Yet a potential impact of NPS on brain morphology, cognitive performance and interactions between them in a longitudinal setting, as well as the potential of using these values as prediction of conversion, have remained questionable. We studied 156 participants with mild cognitive impairment (MCI) from the Alzheimers Disease Neuroimaging Initiative database who maintained the same level of cognitive performance after a 4-year follow-up and compared them to 119 MCI participants who converted to dementia. Additionally, we assessed the same analysis in 170 healthy controls who remained healthy at follow-up. Compared to 15 controls who converted to MCI. Their neuropsychological, neuropsychiatric, and brain morphology data underwent statistical analyses of 1) baseline comparison between the groups; (2) analysis of covariance model controlling for age, sex, education, and MMSE score, to specify the cognitive performance and brain structures that distinguish the two subgroups, and 3) used the significant ANCOVA variables to construct a binary logistic regression model that generates a probability equation for a given individual to convert to a lower cognitive performance state. Results showed that MCI who converted to AD in comparison to those who did not convert, exhibited a higher NPS prevalence, a lower cognitive performance and a higher number of involved brain structures. Furthermore, agitation, memory and the volumes of inferior temporal, hippocampal and amygdala sizes were significant predictors of MCI to AD conversion.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lingfang Yu ◽  
Hua Ni ◽  
Zenan Wu ◽  
Xinyu Fang ◽  
Yan Chen ◽  
...  

Anhedonia is considered as one of the five dimensions of negative symptoms and mainly refers to the reduction of the capacity of feeling pleasure. Increasing evidence suggests that anhedonia in schizophrenia may be partly explained by cognitive impairment. However, the associations between specific cognitive impairment and anhedonia are not fully investigated. The purpose of this study was to examine anticipatory anhedonia, consummatory anhedonia, and their cognitive associations in schizophrenia. A total number of 100 patients with schizophrenia and 67 healthy volunteers were recruited. The clinical symptoms of schizophrenia were assessed. Anticipatory pleasure, consummatory pleasure, and cognitive functions of each participant were measured. Multiple linear regression analysis was performed to investigate the influencing factors of anhedonia in schizophrenia. The results showed no significant differences in sex, age, education year, body mass index (BMI), and marital status between the schizophrenia group and healthy control group (all P &gt; 0.05). Both anticipatory and consummatory pleasure in the schizophrenia group were significantly lower than those in the healthy control group (all P &lt; 0.05). Immediate memory, visual spanning, language, attention, and delayed memory were significantly poorer in the schizophrenia group (all P &lt; 0.05). The results showed that language deficit is an independent risk factor for anticipatory anhedonia (B' = 0.265, P = 0.008, 95% CI: 0.038-0.244), while delayed memory deficit is an independent risk factor for consummatory anhedonia (B' = 0.391, P &lt; 0.001, 95% CI:0.085-0.237). To the best of our knowledge, this is the first study that reported the specific cognitive associations of anhedonia in schizophrenia. The findings have added new evidence on the influencing factors of anhedonia and provided clues for the associations between clinical manifestations of schizophrenia.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Catherine A. Morgan ◽  
Tracy R. Melzer ◽  
Reece P. Roberts ◽  
Kristina Wiebels ◽  
Henk J. M. M. Mutsaerts ◽  
...  

AbstractCerebral blood flow (CBF) measured with arterial spin labelling (ASL) magnetic resonance imaging (MRI) reflects cerebral perfusion, related to metabolism, and arterial transit time (ATT), related to vascular health. Our aim was to investigate the spatial coefficient of variation (sCoV) of CBF maps as a surrogate for ATT, in volunteers meeting criteria for subjective cognitive decline (SCD), amnestic mild cognitive impairment (MCI) and probable Alzheimer’s dementia (AD). Whole-brain pseudo continuous ASL MRI was performed at 3 T in 122 participants (controls = 20, SCD = 44, MCI = 45 and AD = 13) across three sites in New Zealand. From CBF maps that included all grey matter, sCoV progressively increased across each group with increased cognitive deficit. A similar overall trend was found when examining sCoV solely in the temporal lobe. We conclude that sCoV, a simple to compute imaging metric derived from ASL MRI, is sensitive to varying degrees of cognitive changes and supports the view that vascular health contributes to cognitive decline associated with Alzheimer’s disease.


2021 ◽  
Vol 6 (3) ◽  
pp. 1-7
Author(s):  
Muijsers HEC ◽  

Women with a history of preeclampsia and/or Hemolysis Elevated Liver enzymes Low Platelets (HELLP) syndrome report impaired cognitive functioning, such as concentration problems and decreased memory function. The presence of subjective cognitive impairment, depressive symptoms and cognitive deficits may affect working abilities.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyunkyu Kim ◽  
Seung Hoon Kim ◽  
Wonjeong Jeong ◽  
Sung-In Jang ◽  
Eun-Cheol Park ◽  
...  

Abstract Background Muscular function, such as handgrip strength, has been suggested as an associated factor for cognitive impairment. This study investigated the association between temporal change in handgrip strength and cognitive function using longitudinal, nationwide data from Korean older adults. Methods Our study used data from the Korean Longitudinal Study of Aging (KLoSA). The analysis covered 6696 participants who had taken the handgrip strength test and Mini-Mental State Examination (MMSE) from 2006 to 2018. We adopted general estimating equations to assess the temporal effect of handgrip strength change on cognitive function. Results After adjusting for covariates, we observed an association between handgrip strength and low MMSE scores (β = − 0.3142 in men, β = − 0.2685 in women). Handgrip strength as a continuous variable was positively correlated with MMSE scores after adjustment (β = 0.0293 in men, β = 0.0347 in women). The group with decreased handgrip strength over time also showed greater odds for mild cognitive impairment (OR = 1.23, 95%CI = 1.05–1.27 in men, OR = 1.15, 95%CI = 1.05–1.27 in women) and dementia (OR = 1.393, 95%CI = 1.18–1.65 in men, OR = 1.19, 95%CI = 1.08–1.32 in women). Conclusions This study identified the relationship between handgrip strength change and cognitive function among South Korean adults. According to our large, longitudinal sample, decreasing handgrip strength was associated with decline in cognitive function.


2021 ◽  
Vol 73 (12) ◽  
pp. 786-792
Author(s):  
Doonyaporn Wongsawaeng ◽  
Orasa Chawalparit ◽  
Siriwan Piyapittayanan ◽  
Tanyaluck Thientunyakit ◽  
Weerasak Muangpaisan ◽  
...  

Objective: Depression among older adults is frequently an early symptom of cognitive decline, and is believed to be a risk factor for Alzheimer’s disease (AD). Hippocampal subfield volume loss is found in both mild cognitive impairment (MCI) and major depressive disorder (MDD). We aimed to investigate the potential of MR hippocampal subfield volumetry for discriminating among healthy older adults (HOA) and older adults with MCI or MDD. Materials and Methods: Seventy age-matched subjects (29 non-depressed MCI, 12 MDD, and 29 HOA) underwent 3-Tesla MR imaging (MRI) with high-resolution 3D-T1W-TFE whole brain. Hippocampal subfield volumetric measurements were performed using FreeSurfer software to distinguish among MCI, MDD, and HOA. Subgroup analysis with amyloid PET result was also performed.Results: Significantly smaller bilateral hippocampal tail volume was observed in MCI compared to HOA (p=0.004 and p=0.04 on the left and right side, respectively). The same comparative finding was observed at left HATA (hippocampus-amygdala-transition-area) of MCI (p=0.046). Other regions showed non-significantly smaller size in MCI than in HOA [left molecular layer HP (p=0.06), left whole hippocampus (p=0.06), and left CA1 (p=0.07)]. There was a non-significant trend toward smaller size in almost all 13 subfield hippocampal regions of MCI compared to MDD, even in subgroup analysis with amyloid PET result.Conclusion: MR hippocampal subfield volumetry may have value in routine clinical practice for screening individuals with MCI, and may be a valuable adjunct to amyloid PET study for very early-stage diagnosis of AD.


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