cognitive disorder

认知障碍
  • 文章类型: Journal Article
    背景:以前的研究已经研究了认知功能和生活方式之间的关系;然而,这种关系的性质预计在不同的文化和低收入环境中会有所不同,因为生活方式不同于高收入国家。
    目的:本研究旨在调查2021年60岁及以上人群的生活方式因素与认知功能之间的相关性。
    方法:这个横截面,基于社区的研究涉及来自霍拉马巴德综合城市卫生中心的300名老年人,伊朗,通过分层整群抽样选择。使用人口统计信息问卷收集数据,迷你精神状态检查,和生活方式问卷。数据管理和分析采用SPSS(22版)和独立t检验,皮尔逊相关系数,方差分析,采用多元线性回归分析。P值<0.05被认为是显著的。
    结果:该研究包括156名男性(52%)和144名女性(48%)。研究发现认知功能与生活方式之间存在显著相关性(P<0.001)。多元线性回归分析表明,身体健康,环境卫生,锻炼,事故预防,避免用药对认知功能的积极作用最为显著。相反,社会健康对认知功能有显著的负面影响。(P<0.001)。
    结论:结果表明,生活方式的特定方面,比如身体健康,事故预防,避免用药与老年人的认知功能有关。因此,生活方式促进计划可以增强老年人的认知功能并改善其生活质量.
    BACKGROUND: Previous studies have examined relationship between cognitive function and lifestyle; however, the nature of this relationship is expected to vary in diverse cultural and low-income setting where lifestyle practices differ from those in high-income countries.
    OBJECTIVE: This study aims to investigate the correlation between lifestyle factors and cognitive function among individuals aged 60 years and older in 2021.
    METHODS: This cross-sectional, Community-based study involved 300 older adults from comprehensive urban health centers in Khorramabad, Iran, selected through stratified cluster sampling. Data were collected using the demographic information questionnaire, Mini-Mental State Examination, and Lifestyle Questionnaire. Data management and analysis were performed using SPSS (version 22) and independent t-tests, Pearson\'s correlation coefficient, ANOVA, and multiple linear regression analysis were used. A p value < 0.05 was considered significant.
    RESULTS: The study included 156 males (52%) and 144 females (48%). Findings revealed a significant correlation between cognitive function and lifestyle (P < 0.001). Multiple linear regression analysis indicated that physical health, environmental health, exercise, accident prevention, and avoidance of medication exerted the most significant positive effect on cognitive function. Conversely, social health exhibited a notable negative influence on cognitive function. (P < 0.001).
    CONCLUSIONS: The results suggest that specific aspects of lifestyle, such as physical health, accident prevention, and avoidance of medication are associated with cognitive function in older adults. Consequently, lifestyle promotion programs may enhance cognitive function and improve the quality of life among older adults.
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  • 文章类型: Journal Article
    背景:证据表明单纯疱疹病毒(HSV)参与了阿尔茨海默病(AD)的发病机制。
    目的:我们根据疱疹病毒抗体的存在,研究了AD和痴呆的风险,这些抗体与抗疱疹病毒治疗和潜在的APOE®4载体相互作用有关。
    方法:这项研究是对2001-2005年生活在瑞典的1002名无痴呆症的70岁儿童进行的,他们被随访了15年。分析血清样本以检测抗HSV和抗HSV-1免疫球蛋白(Ig)G,抗巨细胞病毒(CMV)IgG,抗HSVIgM,以及抗HSV和抗CMVIgG水平。从医疗记录中收集诊断和药物处方。应用Cox比例风险回归模型。
    结果:累积AD和全因痴呆发生率分别为4%和7%,分别。82%的参与者是抗HSVIgG携带者,其中6%接受了抗疱疹病毒治疗。抗HSVIgG与痴呆风险增加了一倍以上相关(完全校正风险比=2.26,p=0.031)。与AD无显著关联,但风险比与痴呆症的风险比相同。抗HSVIgM和抗CMVIgG患病率,抗疱疹病毒治疗,抗HSV和-CMVIgG水平与AD或痴呆无关,抗HSVIgG与APOEº4或抗CMVIgG之间也没有相互作用。对于HSV-1获得了类似的结果。
    结论:HSV(而非CMV)感染可能是痴呆风险加倍的指标。该队列中的低AD发病率可能损害了检测与AD关联的统计能力。
    UNASSIGNED: Evidence indicates that herpes simplex virus (HSV) participates in the pathogenesis of Alzheimer\'s disease (AD).
    UNASSIGNED: We investigated AD and dementia risks according to the presence of herpesvirus antibodies in relation to anti-herpesvirus treatment and potential APOE ɛ4 carriership interaction.
    UNASSIGNED: This study was conducted with 1002 dementia-free 70-year-olds living in Sweden in 2001-2005 who were followed for 15 years. Serum samples were analyzed to detect anti-HSV and anti-HSV-1 immunoglobulin (Ig) G, anti-cytomegalovirus (CMV) IgG, anti-HSV IgM, and anti-HSV and anti-CMV IgG levels. Diagnoses and drug prescriptions were collected from medical records. Cox proportional-hazards regression models were applied.
    UNASSIGNED: Cumulative AD and all-cause dementia incidences were 4% and 7%, respectively. Eighty-two percent of participants were anti-HSV IgG carriers, of whom 6% received anti-herpesvirus treatment. Anti-HSV IgG was associated with a more than doubled dementia risk (fully adjusted hazard ratio = 2.26, p = 0.031). No significant association was found with AD, but the hazard ratio was of the same magnitude as for dementia. Anti-HSV IgM and anti-CMV IgG prevalence, anti-herpesvirus treatment, and anti-HSV and -CMV IgG levels were not associated with AD or dementia, nor were interactions between anti-HSV IgG and APOE ɛ4 or anti-CMV IgG. Similar results were obtained for HSV-1.
    UNASSIGNED: HSV (but not CMV) infection may be indicative of doubled dementia risk. The low AD incidence in this cohort may have impaired the statistical power to detect associations with AD.
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  • 文章类型: Journal Article
    本研究的目的是探讨弥漫性浸润胶质瘤成年患者的主要症状和主要症状的预后价值,并为评估生存率提供临床观点。
    这项研究包括来自两家三级大学医院的回顾性队列(2006-2013年,坦佩雷大学医院和图尔库大学医院n=604)和前瞻性队列(2014-2018年,坦佩雷大学医院n=156)。术前症状分为主要症状和主要症状。结果用较新的WHO2021分类标准进行了验证。
    最常见的首发症状是癫痫发作(30.8%的回顾性分析,28.2%预期),认知障碍(13.2%回顾性,16.0%预期),头痛(8.6%回顾性,12.8%预期),和运动障碍(7.0%回顾性,7.1%预期)。在回顾性队列中,预测更好生存的症状是癫痫发作和视觉或其他影响感觉的症状,在前瞻性队列中,癫痫发作和头痛。生存不良的预测因素是认知障碍,运动功能障碍,感觉症状,肿瘤出血,回顾性队列和认知障碍中的言语障碍和头晕,运动功能障碍,感觉症状,前瞻性队列中的头晕。在多变量模型中,运动功能障碍是生存的独立预测因子(OR=1.636)。
    弥漫性神经胶质瘤的主要症状与回顾性和前瞻性预后相关。在2-4级弥漫性胶质瘤的多变量分析中,运动性轻瘫是低生存率的独立预后因素。尤其是胶质母细胞瘤。
    UNASSIGNED: The objectives of this study were to investigate the prognostic value of primary symptoms and leading symptoms in adult patients with diffuse infiltrating glioma and to provide a clinical perspective for evaluating survival.
    UNASSIGNED: This study included a retrospective cohort from two tertiary university hospitals (n = 604, 2006-2013, Tampere University Hospital and Turku University Hospital) and a prospective cohort (n = 156, 2014-2018, Tampere University Hospital). Preoperative symptoms were divided into primary and leading symptoms. Results were validated with the newer WHO 2021 classification criteria.
    UNASSIGNED: The most common primary symptoms were epileptic seizure (30.8% retrospective, 28.2% prospective), cognitive disorder (13.2% retrospective, 16.0% prospective), headache (8.6% retrospective, 12.8% prospective), and motor paresis (7.0% retrospective, 7.1% prospective). Symptoms that predicted better survival were epileptic seizure and visual or other sense-affecting symptom in the retrospective cohort and epileptic seizure and headache in the prospective cohort. Predictors of poor survival were cognitive disorder, motor dysfunction, sensory symptom, tumor hemorrhage, speech disorder and dizziness in the retrospective cohort and cognitive disorder, motor dysfunction, sensory symptom, and dizziness in the prospective cohort. Motor dysfunction served as an independent predictor of survival in a multivariate model (OR = 1.636).
    UNASSIGNED: Primary and leading symptoms in diffuse gliomas are associated with prognoses in retrospective and prospective settings. Motor paresis was an independent prognostic factor for poor survival in multivariate analysis for grade 2-4 diffuse gliomas, especially in glioblastomas.
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  • 文章类型: English Abstract
    支持患有神经进化疾病的老年人是一项复杂的任务,特别是如果这个人有认知问题,住在疗养院。非药物方法为传统治疗和护理提供了很好的替代方案。越来越多的基于戏剧即兴表演的疗法正在发展起来,以促进心理健康。这项研究的目的是研究在8周内参加戏剧即兴工作坊对生活质量的影响,自尊,10名患有轻度认知障碍的老年人(平均值=87.70岁;SD=2.87岁)的抑郁症状和个人满意度。在剧院会议结束时,参与者报告心理健康更好。这项研究为患有神经进化疾病的老年人非药物介导的发展提供了见解。
    Supporting an elderly person with a neuro-evolutionary disease is a complex task, especially if the person has cognitive problems and lives in a nursing home. Non-drug approaches offer good alternatives to traditional treatment and care. More and more therapies based on theatrical improvisation are being developed to act on psychological health. The aim of this research is to study the effect of participation in theatrical improvisation workshops over a period of 8 weeks on quality of life, self-esteem, depressive symptoms and personal satisfaction in 10 elderly people (Mean = 87.70 years; SD = 2.87 years) with mild cognitive impairment. At the end of the theatre sessions, the participants reported better psychological health. This study provides insights into the development of non-drug mediations for elderly people with neuro-evolutionary diseases.
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  • 文章类型: Journal Article
    目的:由SARS-CoV-2病毒引起的COVID-19是严重急性呼吸道综合征(SARS)的新病因。对这些患者的短期认知预后知之甚少。我们前瞻性评估了重症监护病房(ICU)护理后不久和3个月后ICU后COVID-19患者的基本认知功能。
    方法:我们在巴黎的机构进行了一项前瞻性单中心研究。SARS-CoV-2SARS患者是通过我们的ICU前瞻性招募的。在基线和随访三个月时使用标准化认知测试对患者进行评估。我们的主要终点是以下五项全球测试的演变:MMSE,FAB,口头命名测试,Dubois五个单词测试和MADRS。
    结果:我们在基线和随访时调查了13例患者。所有患者在基线时都有认知障碍,但在三个月时都有所改善,在Bonferroni校正多重测试后的五项全球测试中,有两项显着:MMSE(中位数分别为18(IQR[15-22])和27(IQR[27-29]),P=0.002)和FAB测试(中位数分别为14(IQR[14-17])和17(IQR[17,18]),P=0.002)。
    结论:我们在此报告COVID-19患者重症监护后短期认知障碍的第一个纵向数据。我们发现急性和短期认知障碍,但在三个月时有显着改善。这种模式似乎与重症监护后综合征的其他原因没有区别。
    OBJECTIVE: COVID-19 due to SARS-CoV-2 virus is a new cause of severe acute respiratory syndrome (SARS). Little is known about the short-term cognitive prognosis for these patients. We prospectively evaluated basic cognitive functions shortly after care in the intensive care unit (ICU) and three months later in post-ICU COVID-19 patients.
    METHODS: We performed a prospective single-center study in our institution in Paris. Patients with SARS-CoV-2 SARS were prospectively recruited via our ICU. Patients were evaluated using standardized cognitive tests at baseline and at three months\' follow-up. Our primary endpoint was the evolution of the following five global tests: MMSE, FAB, oral naming test, Dubois five words test and MADRS.
    RESULTS: We explored 13 patients at baseline and follow-up. All patients had cognitive impairment at baseline but they all improved at three months, significantly on two of the five global tests after Bonferroni correction for multiple testing: MMSE (median 18 (IQR [15-22]) and 27 (IQR [27-29]) respectively, P=0.002) and FAB test (median 14 (IQR [14-17]) and 17 (IQR [17,18]) respectively, P=0.002).
    CONCLUSIONS: We report here the first longitudinal data on short-term cognitive impairment after intensive care in COVID-19 patients. We found acute and short-term cognitive impairment but significant improvement at three months. This pattern does not seem to differ from other causes of post-intensive care syndrome.
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  • 文章类型: Journal Article
    已知间歇性theta爆发刺激(iTBS)可改善由阿尔茨海默病和帕金森病引起的认知障碍,但缺乏关于iTBS对卒中后认知障碍(PSCI)疗效的研究.
    本研究旨在探讨左背外侧前额叶皮质(DLPFC)iTBS对改善卒中患者认知功能的作用。
    58例PSCI患者随机分为iTBS(n=28)和假刺激组(n=30)。两组均接受常规认知相关康复治疗。iTBS组接受左侧DLPFC的iTBS干预,假刺激组在相同部位用相同参数治疗2周。结果测量在基线(T0)和最后一次干预(T1)后立即通过小型精神状态检查(MMSE)进行评估。牛津认知屏幕,和事件相关电位P300。
    两组之间的基线临床特征没有差异。干预后,两组的MMSE评分和P300振幅均显著增加,P300潜伏期明显缩短。iTBS组的变化值显著高于假刺激组(p<0.05)。与假刺激组相比,iTBS组在语义理解和执行功能方面有更显著的变化(p<0.05)。
    iTBS能有效、安全地改善卒中患者的整体认知障碍,包括语义理解和执行功能,对记忆功能也有积极的影响。未来应进行大样本随机对照研究和长期随访,以进一步验证本研究的结果。
    Intermittent theta burst stimulation (iTBS) is known to improve cognitive impairment caused by Alzheimer\'s disease and Parkinson\'s disease, but studies are lacking with respect to the efficacy of iTBS on poststroke cognitive impairment (PSCI).
    This study was conducted to investigate the effect of left dorsolateral prefrontal cortex (DLPFC) iTBS on improving cognitive function in stroke patients.
    Fifty-eight patients with PSCI are randomly divided into iTBS (n = 28) and sham stimulation groups (n = 30). Both groups receive routine cognitive-related rehabilitation. The iTBS group is treated with iTBS intervention of the left DLPFC, and the sham stimulation group is treated with the same parameters at the same site for 2 weeks. Outcome measures are assessed at baseline (T0) and immediately after the last intervention (T1) by mini-mental state examination (MMSE), Oxford cognitive screen, and event-related potential P300.
    There are no differences in baseline clinical characteristics between the two groups. After intervention, the MMSE scores and P300 amplitude increase significantly for both groups, and the P300 incubation period reduces significantly. The change value of the iTBS group is significantly higher than that of sham stimulation group (p < .05). Compared with the sham stimulation group, the iTBS group has more significant changes in semantic comprehension and executive function (p < .05).
    iTBS can effectively and safely improve overall cognitive impairment in stroke patients, including semantic understanding and executive function, and it also has a positive impact on memory function. Future randomized controlled studies with large samples and long-term follow-up should be conducted to further validate the results of the present study.
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  • 文章类型: Journal Article
    背景:慢性非传染性疾病如2型糖尿病(T2DM)和痴呆的患病率随年龄增长而增加。在这种情况下,文献中已经描述了T2DM和认知障碍之间的关联.然而,在西班牙裔人群中的研究很少。该研究项目提出了一项试点研究,该研究将评估DIABDEM项目的可行性,该项目将确定西班牙和智利诊断为T2DM的老年人认知障碍的患病率。
    方法:这是一项基于观察的试点研究,非实验性的,描述性比较和横断面。样本将涉及72名参与者(39名西班牙人和33名智利人),65岁或以上,男人和女人,社区住宅,以前没有被诊断出患有痴呆症的人,有或没有T2DM诊断。参与者将填写一份研究协议表格,收集社会人口统计学和临床数据,生活方式细节,和神经心理学变量。
    结果:本研究将评估DIABDEM项目的可行性,该项目将确定T2DM老年人认知障碍的患病率。一方面,本研究的目的是确定与T2DM认知功能障碍发展潜在相关的风险和保护因素.另一方面,它有望确定T2DM患者的特定神经心理学特征,后来提出了一个简短而有用的神经心理学电池,以区分T2DM患者的早期认知障碍。
    结论:本试验研究的结果将获得有关DIABDEM项目可行性的更多知识,这将提供有关T2DM认知并发症的证据。
    BACKGROUND: The prevalence of chronic noncommunicable diseases such as type 2 diabetes mellitus (T2DM) and dementia increase with ageing. In this context, an association between T2DM and cognitive impairment has been described in the literature. However, there are few studies in the Hispanic population. This research project presents a pilot study that will evaluate the feasibility of the DIABDEM project that will determine the prevalence of cognitive impairment in old people with diagnosis of T2DM in Spain and Chile.
    METHODS: It is a observation-based pilot study, non-experimental, descriptive-comparative and cross-sectional. The sample will involve 72 participants (39 Spaniards and 33 Chileans), 65 year-old or older, men and women, community dwelling, and who have not been previously diagnosed with dementia, with or without a T2DM diagnosis. Participants will fill in a research protocol form collecting socio-demographic and clinical data, lifestyle details, and neuropsychological variables.
    RESULTS: This study will evaluate the feasibility of the DIABDEM project that will determine the prevalence rate of cognitive impairment in old people with T2DM. On one hand, the aim of this study will establish risk and protectors factors potentially associated with the development of cognitive impairment in T2DM. On the other hand, it is expected to identify a specific neuropsychological profile in people with T2DM, proposing later a brief and useful neuropsychological battery in order to discriminate early cognitive impairment in people with T2DM.
    CONCLUSIONS: Findings in this pilot study will obtain greater knowledge about the feasibility of the DIABDEM project, which will provide evidence about cognitive complications in T2DM.
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  • 文章类型: Journal Article
    Background: Dementia is a public health priority with a dramatic social and economic impact on people with dementia (PwD), their caregivers and societies. The aim of this study was to contribute to the knowledge on how utilization of formal and informal care varies between Sweden and Italy. Methods: Data were retrieved from two trials: TECH@HOME (Sweden) and UP-TECH (Italy). The sample consisted of 89 Swedish and 317 Italian dyads (PwD and caregivers). Using bivariate analysis, we compared demographic characteristics and informal resource utilization. Multiple linear regression was performed to analyze factors associated with time spent on care by the informal caregivers. Results: Swedish participants utilized more frequently health care and social services. Informal caregivers in Italy spent more time in caregiving than the Swedish ones (6.3 and 3.7 h per day, respectively). Factors associated with an increased time were country of origin, PwD level of dependency, living situation, use of formal care services and occupation. Conclusions: Care and service utilization significantly varies between Sweden and Italy. The level of formal care support received by the caregivers has a significant impact on time spent on informal care. Knowledge on the factors triggering formal care resources utilization by PwD and their caregivers might further support care services planning and delivery across different countries.
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  • 文章类型: Journal Article
    This study aimed to examine the effect of docosahexaenoic acid (DHA)-enriched fish oil supplement and meal of grilled fish on cognitive and behavioral functioning manifested as attention-deficit/hyperactivity disorder in primary school students 9 to 10 y of age in Muscat, Oman.
    This randomized open-label trial involved two types of interventions: fish oil supplement or one serving (100 g) of grilled fish per day (Sunday through Friday) for 12 weeks. Red cell total lipid DHA levels were assessed. The Verbal Fluency Test, Buschke Selective Reminding Test, and Trail Making Test were used to measure cognitive functioning. Behavioral functioning was assessed using a standardized Arabic version of the National Initiative for Children\'s Health Quality Vanderbilt Assessment Scales. All measurements were carried out before and after intervention.
    DHA levels increased by 72% and 64% in the fish oil (mean, 3.6%-6.2%) and fish-meal (mean, 3.4%-5.6%) groups, respectively (P = 0.000). The Trail Making Test was the only cognitive test that demonstrated marked differences between groups: Median interquartile range difference between pre- and postintervention in the Trail Making Part B score was 61.5 (SE, 19.3, 103.2) in the fish oil versus fish-meal group, 24.5 (SE, -15.2, 74.7, P = 0.005). The Vanderbilt Assessment Scales also showed significant differences between groups (P < 0.001).
    This study contributed to available evidence on the cognitive and behavioral benefits of DHA in healthy school children. Expanding the food fortification program with DHA-enriched fish oil should be considered as part of broader policy to improve child health.
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  • 文章类型: Journal Article
    Defining the primary cognitive endpoint is a major decision for Alzheimer\'s disease preventive trials. As an example for further trials we present in detail the three-year cognitive decline in the placebo group of MAPT trial, a randomized controlled trial (RCT) using a cognitive composite score (MAPT-PACC). Participants were dementia-free adults 70 years or older, with subjective memory complaints. Our findings as expected showed subjects with older age (>75), higher beta amyloid brain deposition, APOE-ε4 allele carriers, with low RBC DHA+EPA levels and higher CDR level are at higher risk of cognitive decline. The data presented in this paper can be useful for future preventive trials to choose the primary cognitive end point, assess the clinical relevance of cognitive changes and perform sample size calculation for several targeted population eg. ApoE4, amyloid +, oldest old, lower n3-PUFA. We believe that the trial group with CDR 0.5, without being selected by a memory test endpoint is a good target population for AD preventive trials.
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