Alzheimer's

老年痴呆症
  • 文章类型: Journal Article
    代谢改变通常与神经退行性疾病共存的发现引起了对代谢调节因子作为大脑健康潜在调节剂的检查的兴趣。这里,我们检查了脂肪因子(瘦素,脂联素,抵抗素,和IL6)和胰岛素对阿尔茨海默病频谱参与者脑萎缩的不同标记。我们纳入了来自阿尔茨海默病神经影像学倡议(ADNI)数据集的566名参与者,其中1063个随访时间点(平均随访时间:一年);并检查了代谢调节因子与体积MRI值之间的关联。白质高强度,和认知障碍的测量。更高的瘦素,抵抗素,IL6和胰岛素与脑萎缩的标志物有关,如较低的大脑总体积,或更高的心室容积。较高的瘦素和抵抗素也与日常生活活动的更大损害有关。较高的脂联素与较低的心室容积有关。脂肪因子或胰岛素与白质高信号之间没有关联。我们的发现表明,在阿尔茨海默病的临床前至临床范围内,代谢调节因子和脑容量的变化之间存在共同发生。这些结果表明,旨在促进代谢健康的策略可能会对大脑健康产生积极影响。
    The discovery that metabolic alterations often coexist with neurodegenerative conditions has sparked interest in the examination of metabolic regulatory factors as potential modulators of brain health. Here, we examined the role of adipokines (leptin, adiponectin, resistin, and IL6) and insulin on different markers of brain atrophy in participants on the spectrum of Alzheimer\'s Disease. We included 566 participants from the Alzheimer\'s Disease Neuroimaging Initiative (ADNI) dataset with 1063 follow-up time points (average follow-up: one year); and examined the association between metabolic regulatory factors and volumetric MRI values, white matter hyperintensities, and measures of cognitive impairment. Higher leptin, resistin, IL6, and insulin were associated with markers of cerebral atrophy, such as lower total brain volume, or higher ventricular volume. Higher leptin and resistin were also associated with greater impairment in daily life activities. Higher adiponectin was associated with lower ventricle volume. There was no association between adipokines or insulin with white matter hyperintensities. Our findings indicate a co-occurrence between alterations in metabolic regulatory factors and in brain volume along the preclinical to clinical spectrum of Alzheimer\'s Disease. These results suggest that strategies aimed at promoting metabolic health may positively impact brain health.
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  • 文章类型: Journal Article
    背景:痴呆和肝性脑病(HE)有症状重叠,难以区分。未确诊的肝硬化的存在可能导致错过治疗HE的机会,在退伍军人数据库中找到的.这需要在非退伍军人队列中进行验证。
    方法:在2009年至2019年期间,使用来自多中心TriNetX数据库的国家非退伍军人患者数据进行了一项回顾性队列研究。参与者包括68,807名痴呆诊断≥2次就诊的患者,事先没有肝硬化的诊断,并有足够的实验室测试结果来计算纤维化-4(FIB-4)指数,这表明肝脏疾病。在队列中测量高FIB-4评分(>2.67和>3.25)的患病率,并检查了高FIB-4与合并症/人口统计学之间的关联。
    结果:在队列中(男性占44.7%,78.0%白色,平均年龄72.73岁(±11.09)),7.6%(n=5815)的FIB-4指数>3.25,12.8%(n=8683)的FIB-4指数>2.67。在多变量逻辑回归模型中,FIB-4>3.25与男性相关(OR:1.42[1.33-1.51]),充血性心力衰竭(OR:1.73[1.59-1.87]),病毒性肝炎(OR:2.23[1.84-2.68]),酒精使用障碍(OR:1.39[1.22-1.58]),和慢性肾脏疾病(OR:1.38[1.28-1.48]),与白种人(OR:0.76[0.71-0.82])和糖尿病(OR:0.82[0.77-0.88])呈负相关。类似的发现与FIB-4>2.67阈值相关。
    结论:本国家队列研究的结果表明,FIB-4指数可用于筛查痴呆患者潜在的未确诊肝硬化和可能被误诊为痴呆或导致痴呆患者认知功能恶化的肝性脑病。
    BACKGROUND: Dementia and hepatic encephalopathy (HE) have symptom overlap and are challenging to differentiate. The presence of undiagnosed cirrhosis may lead to missed opportunities to treat HE, which was found in a Veterans database. This needs validation in a non-Veteran cohort.
    METHODS: A retrospective cohort study was conducted between 2009 and 2019 using national non-Veteran patient data from the multi-center TriNetX database. Participants included 68,807 patients with a dementia diagnosis at ≥2 visits, no prior diagnosis of cirrhosis, and with sufficient laboratory test results to calculate the Fibrosis-4 (FIB-4) index, which indicates liver disease. Prevalences of high FIB-4 scores (>2.67 and >3.25) were measured within the cohort, and associations between high FIB-4 and comorbidities/demographics were examined.
    RESULTS: Within the cohort (44.7% male, 78.0% white, mean age 72.73 years (±11.09)), 7.6% (n = 5815) had a FIB-4 index >3.25 and 12.8% (n=8683) had FIB-4 >2.67. In multivariable logistic regression models, FIB-4 > 3.25 was associated with male gender (OR: 1.42 [1.33-1.51]), congestive heart failure (OR:1.73 [1.59-1.87]), viral hepatitis (OR: 2.23 [1.84-2.68]), alcohol use disorder (OR: 1.39 [1.22-1.58]), and chronic kidney disease (OR: 1.38 [1.28-1.48]), and inversely associated with white race (OR: 0.76 [0.71-0.82]) and diabetes (OR: 0.82 [0.77-0.88]). Similar findings were associated with the FIB-4 > 2.67 threshold.
    CONCLUSIONS: The findings of this national cohort suggest that the FIB-4 index could be utilized to screen for potential undiagnosed cirrhosis in patients with dementia and that hepatic encephalopathy that might be misdiagnosed as dementia or cause worsening of cognitive function in patients with dementia.
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  • 文章类型: Journal Article
    背景:患有痴呆症的人和非正式照顾者营养不良的风险更高。大多数护理人员不是识别痴呆症营养并发症的专家。因此,我们旨在确定与喂养和照顾痴呆症患者相关的营养知识和挑战,以制定有意义的干预措施。
    方法:采用混合方法。八个焦点小组与痴呆症患者(n=28)和医疗保健专业人员(n=23)的护理人员进行了研究。使用NVivo软件分析数据。进行问卷调查以确定营养挑战。改良的食物频率问卷评估了护理人员和痴呆症患者的食物模式。将结果与地中海-DASH干预神经退行性延迟(MIND)饮食指南进行比较。数据采用SPSS软件进行分析。
    结果:出现了四个主要主题:忘记吃饭,发展厌恶食物,对甜食和体重变化的强烈偏好。研究结果表明,用于改善营养摄入的常见策略包括暗示,补充和安静的饮食环境。护理人员受到压力的影响,导致食物选择和精疲力竭。参与者对护理人员计划的建议包括教育,资源和支持。食物频率问卷调查的结果显示,与MIND饮食指南相比,大多数参与者的饮食多样性较低。
    结论:两组患者更容易营养不良,这项研究表明,参与者获得大脑健康所需的足够营养的可能性较小。此外,照顾者自己和他们的痴呆症患者正在处理营养问题。研究结果支持注册营养师需要为这些家庭提供量身定制的营养干预措施。
    BACKGROUND: Persons living with dementia and informal caregivers are at a higher risk for malnutrition. Most caregivers are not experts at identifying nutritional complications of dementia. Therefore, we aimed to identify nutrition knowledge and challenges related to feeding and caring for persons with dementia to develop a meaningful intervention.
    METHODS: A mixed-methods approach was used. Eight focus groups were conducted with caregivers of persons living with dementia (n = 28) and healthcare professionals (n = 23). Data was analysed using NVivo software. A questionnaire was administered to identify nutritional challenges. A modified food frequency questionnaire assessed food patterns of caregivers and persons with dementia. Results were compared to Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) dietary guidelines. Data were analysed using SPSS software.
    RESULTS: Four major themes emerged: forgetting to eat, developing food aversions, strong preferences for sweets and weight changes. Findings revealed common strategies used to improve nutrition intake included cueing, supplements and quiet eating environment. Caregivers were impacted by stress leading to poorer food choices and exhaustion. Recommendations for a caregiver program made by participants included education, resources and support. Findings from the food frequencies questionnaire survey showed most participants had a lower dietary diversity compared to the MIND diet guidelines.
    CONCLUSIONS: With both groups being more prone to malnutrition, this research shows that participants were less likely to obtain adequate nutrition for brain health. Additionally, caregivers are dealing with nutrition issues themselves and their person living with dementia. The findings support the need for registered dietitians to provide tailored nutrition interventions for these families.
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  • 文章类型: Journal Article
    背景:在阿尔茨海默病(AD)和其他tau蛋白病中发现了由tau蛋白组成的神经内包涵体。Tau通常结合微管(MT),它与MT的脱离和AD中的错误折叠被认为会导致MT异常。我们先前鉴定了在AD小鼠模型中提供益处的含三唑并嘧啶的MT稳定化合物,并在本文中描述了优化的候选物的表征和功效测试。CNDR-51997。
    方法:CNDR-51997经历了药代动力学,药效学,安全药理学,和小鼠耐受性测试。此外,检查化合物在5XFAD淀粉样蛋白β(Aβ)斑块小鼠和PS19tau蛋白病小鼠中的功效。
    结果:CNDR-51997显着减少了5XFAD小鼠的Aβ斑块和PS19小鼠的tau病理,后者也表现出减弱的轴突营养不良和神经胶质增生。CNDR-51997在超过疗效剂量的剂量下耐受性良好,具有良好的安全药理学特征。
    结论:CNDR-51997可能是作为AD和/或其他tau蛋白病变的潜在治疗药物的候选药物。在阿尔茨海默病(AD)脑和AD病理学小鼠模型中存在微管改变(MT)的证据。间歇给药与优化,脑渗透剂MT稳定小分子,CNDR-51997减少了建立的AD小鼠模型中的Aβ斑块和tau包涵体病理学。CNDR-51997在tau蛋白病小鼠模型中减轻轴突营养不良和神经胶质增生,具有减少海马神经元丢失的强烈趋势。CNDR-51997在小鼠中具有良好的耐受性,其剂量明显大于AD小鼠模型中功效所需的剂量。该化合物具有良好的安全药理学特征。
    BACKGROUND: Intraneuronal inclusions composed of tau protein are found in Alzheimer\'s disease (AD) and other tauopathies. Tau normally binds microtubules (MTs), and its disengagement from MTs and misfolding in AD is thought to result in MT abnormalities. We previously identified triazolopyrimidine-containing MT-stabilizing compounds that provided benefit in AD mouse models and herein describe the characterization and efficacy testing of an optimized candidate, CNDR-51997.
    METHODS: CNDR-51997 underwent pharmacokinetic, pharmacodynamic, safety pharmacology, and mouse tolerability testing. In addition, the compound was examined for efficacy in 5XFAD amyloid beta (Aβ) plaque mice and PS19 tauopathy mice.
    RESULTS: CNDR-51997 significantly reduced Aβ plaques in 5XFAD mice and tau pathology in PS19 mice, with the latter also showing attenuated axonal dystrophy and gliosis. CNDR-51997 was well tolerated at doses that exceeded efficacy doses, with a good safety pharmacology profile.
    CONCLUSIONS: CNDR-51997 may be a candidate for advancement as a potential therapeutic agent for AD and/or other tauopathies. Highlights There is evidence of microtubule alterations (MT) in Alzheimer\'s disease (AD) brain and in mouse models of AD pathology. Intermittent dosing with an optimized, brain-penetrant MT-stabilizing small-molecule, CNDR-51997, reduced both Aβ plaque and tau inclusion pathology in established mouse models of AD. CNDR-51997 attenuated axonal dystrophy and gliosis in a tauopathy mouse model, with a strong trend toward reduced hippocampal neuron loss. CNDR-51997 is well tolerated in mice at doses that are meaningfully greater than required for efficacy in AD mouse models, and the compound has a good safety pharmacology profile.
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  • 文章类型: Journal Article
    背景:阿尔茨海默病(AD)是痴呆症的最常见形式,预计将来会大大增加,使其成为全球重大健康问题,对个人和社会产生严重影响。尽管近几十年来在了解阿尔茨海默病(AD)的细胞和分子方面取得了进展,这仍然是一个重大问题。一个主要问题是准确地将药物输送到患病的神经元,同时最大限度地减少对健康神经元的影响。抗阿尔茨海默病药物的低水溶性和阻碍高亲脂性中枢神经系统药物进入的血脑屏障(BBB)使这一困难恶化。
    目的:本文的重点是基于脂质的纳米载体。这是更广泛接受的治疗阿尔茨海默病的方法之一,因为它增加治疗功效,同时减少与合作神经障碍有效载荷相关的副作用。
    方法:在许多数据库中搜索了以标题发表的论文(包括PubMed,Elsevier,和谷歌学者)。
    结论:纳米脂质载体(NLC)由于其爱脂特性和与活组织的相容性而被认为具有有效靶向大脑的能力。它们改善了药物在大脑中的吸收,同时减少了药物在非预期器官中的积累。这项工作强调了纳米脂质载体的重要性,它们是亲脂性和生物相容性的,并且已经证明了卓越的靶向效率,使它们成为向大脑输送药物的理想载体系统。
    BACKGROUND: Alzheimer\'s disease (AD) is the most common form of dementia and is expected to greatly rise in future, making it a major worldwide health concern with severe impacts on individuals and society. Despite advancements in understanding the cellular and molecular aspects of Alzheimer\'s disease (AD) in recent decades, it still poses a significant problem. A major problem is accurately delivering drugs to diseased neurons while minimising effects on healthy neurons. This difficulty is worsened by the low water solubility of anti-Alzheimer\'s disease medicines and the blood-brain barrier (BBB) that hinders the entry of central nervous system pharmaceuticals that are highly lipophilic.
    OBJECTIVE: The focus of this article is on nanocarriers that are lipid-based. This is one of the more widely accepted methods of treating Alzheimer\'s disease, as it increases therapeutic efficacy while decreasing side effects related to cooperated neurological disorder payload.
    METHODS: Searched many databases for papers published under the title (including PubMed, Elsevier, and Google Scholar).
    CONCLUSIONS: Nano Lipid Carriers (NLCs) are recognized for their ability to target the brain effectively due to their lipid-loving properties and compatibility with living tissues. They improve the absorption of drugs in the brain while decreasing the accumulation of drugs in unintended organs. This work emphasises the importance of nano lipid carriers, which are lipophilic and biocompatible and have demonstrated exceptional targeting efficiency, making them an ideal carrier system for delivering medications to the brain.
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  • 文章类型: Journal Article
    目的:美国食品和药物管理局于2023年1月授权lecanemab用于阿尔茨海默病(AD)的治疗用途。为了评估lecanemab治疗AD的有效性和安全性,我们彻底检查了目前可获得的研究。
    方法:遵循系统评价和Meta分析建议的首选报告项目。为了找到有关lecanemab的相关研究,我们通过PubMed利用电子数据库MEDLINE进行了彻底的文献检索,科克伦,WebofScience,EBSCOhost,还有Scopus.不包括任何使用实验动物的研究,我们在人体临床试验中观察了lecanemab治疗AD的有效性和副作用。纳入3项随机对照研究。
    结果:根据研究,Llecanemab可减轻临床恶化并减少脑淀粉样β斑块(差异,.45;95%置信区间,.67至23;p<.001)。接受lecanemab的参与者发现淀粉样蛋白相关成像异常(ARIA)-H的频率更高(17.3%vs.9.0%)和ARIA-E(12.6%与1.7%),这是一个重大的不利结果。
    结论:Lecanemab已被证明对AD的两个主要病理生理指标(Aβ和tau)有影响。仍然有很多与莱卡尼玛有关的未解决的问题。建议对lecanemab的有效性和安全性进行未来研究,以确定该药物的优点超过缺点。
    OBJECTIVE: The US Food and Drug Administration authorized lecanemab for the therapeutic use of Alzheimer\'s disease (AD) in January 2023. To assess the effectiveness and safety of lecanemab in treating AD, we thoroughly examined the studies that are currently accessible.
    METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations were followed. In order to find relevant studies on lecanemab, we carried out a thorough literature search utilizing the electronic databases MEDLINE via PubMed, Cochrane, Web of Science, EBSCOhost, and Scopus. Excluding any research using experimental animals, we looked at lecanemab\'s effectiveness and side effects in treating AD in human clinical trials. Three randomized controlled studies were included.
    RESULTS: According to studies, lecanemab lessens clinical deterioration and reduces brain amyloid-beta plaques (difference,.45; 95% confidence interval,.67 to.23; p < .001). Participants who received lecanemab saw a greater frequency of amyloid-related imaging abnormalities (ARIA)-H (17.3% vs. 9.0%) and ARIA-E (12.6% vs. 1.7%), which is a significant adverse outcome.
    CONCLUSIONS: Lecanemab has been shown to have an impact on the two primary pathophysiologic indicators of AD (Aβ and tau). There are still a lot of unresolved issues related to lecanemab. Future research on the effectiveness and safety of lecanemab is advised in order to determine that the advantages of this medication exceed the disadvantages.
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  • 文章类型: Journal Article
    目的:开发了一系列新的1,2,3-三唑-腙衍生物以评估其抗阿尔茨海默病活性。材料和方法:通过改良的Ellman方法筛选针对胆碱酯酶的所有化合物。对SH-SY5Y细胞的毒性试验采用MTT法,和GSK-3α的表达水平,GSK-3β,在化合物6m和6p存在下评估DYRK1和CDK5。结果:6m和6p;作为混合型抑制剂,表现出良好的乙酰胆碱酯酶和丁酰胆碱酯酶抑制活性,分别。6m证明在测试浓度下对SH-SY5Y细胞没有毒性并且积极影响神经变性途径。值得注意的是,6m显示GSK-3αmRNA水平显著下调,GSK-3β和CDK5。结论:目标化合物可用于开发抗阿尔茨海默病药物。
    [方框:见正文]。
    Aim: A new series of 1,2,3-triazole-hydrazone derivatives were developed to evaluate their anti-Alzheimer\'s activity. Materials & methods: All compounds were screened toward cholinesterases via the modified Ellman\'s method. The toxicity assay on SH-SY5Y cells was performed using the MTT assay, and the expression levels of GSK-3α, GSK-3β, DYRK1 and CDK5 were assessed in the presence of compounds 6m and 6p. Results: 6m and 6p; acting as mixed-type inhibitors, exhibited promising acetylcholinesterase and butyrylcholinesterase inhibitory activity, respectively. 6m demonstrated no toxicity under tested concentrations on the SH-SY5Y cells and positively impacted neurodegenerative pathways. Notably, 6m displayed a significant downregulation in mRNA levels of GSK-3α, GSK-3β and CDK5. Conclusion: The target compounds could be considered in developing anti-Alzheimer\'s disease agents.
    [Box: see text].
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  • 文章类型: Journal Article
    背景:乙酰白藜芦醇(AC-Res),到目前为止,是有机地产生或作为植物防御系统的组成部分的强大的二苯乙烯植物抗毒素,是重要的植物酚类化学部分,并作为许多疾病的治疗选择进行了研究。由于其稳定性不足和相当大的构象刚度,AC-Res作为药物的效用是有限的。
    目的:当前的评论文章概述了AC-Res的结构,他们的活动方法,以及这些分子管理的最新技术进步。可以想象得出AC-Res对感染细胞的细胞功能具有多种后果。
    方法:本文的文献调查来自各种同行评审出版商发布的真实数据,这些出版商采用GoogleScholar和PubMedprioritizingScopus和WebofScience索引期刊作为搜索平台,专注于AC-Res药理作用,尤其是英语。
    结果:尽管其广泛的生物和治疗应用,AC-Res已成为日益关注的来源。取决于研究人员,AC-Res具有防辐射功能,心脏保护,神经学,抗炎,和抗微生物潜力。它还具有抗癌和抗氧化特性。
    结论:为了避免非特异性细胞毒性,优化工作目前正在强调基于纳米晶体的AC-Res的可能使用,纳米粒子和树枝状聚合物,和纳米晶体。最后,虽然在生物学中使用AC-Res还有很长的路要走,研究人员一致认为,如果他们继续探索它,AC-Res和类似部件将被认为是未来几年内各种事物的实际可能性。
    BACKGROUND: Acetylresveratrol (AC-Res), to date, is a powerful stilbene phytoalexin generated organically or as a component of a plant\'s defensive system, is a significant plant phenolic chemical portion and is investigated as a therapy option for a number of disorders. Owing to its inadequate stabilisation and considerable conformation rigidity, the utility of AC-Res as a medication is limited.
    OBJECTIVE: The current review article outlined the structure of AC-Res, their methods of activity, and the latest technological progress in the administration of these molecules. It is conceivable to deduce that AC-Res has a variety of consequences for the cellular functions of infected cells.
    METHODS: The literature survey for the present article was gathered from the authentic data published by various peer-reviewed publishers employing Google Scholar and PubMedprioritizing Scopus and Web of Science indexed journals as the search platform focusing on AC-Res pharmacological actions, particularly in the English language.
    RESULTS: Despite its extensive spectrum of biological and therapeutic applications, AC-Res has become a source of increasing concern. Depending on the researchers, AC-Res possesses radioprotective, cardioprotective, neurological, anti-inflammatory, and anti-microbial potential. It also has anti-cancer and antioxidant properties.
    CONCLUSIONS: To avoid non-specific cytotoxicity, optimization efforts are presently emphasizing the possible usage of AC-Res based on nanocrystals, nanoparticles and dendrimers, and nanocrystals. Finally, while using AC-Res in biology is still a way off, researchers agree that if they continue to explore it, AC-Res and similar parts will be recognized as actual possibilities for a variety of things in the next years.
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  • 文章类型: Journal Article
    与年龄相关的认知和情感障碍构成了重大的公共卫生挑战。值得注意的是,情绪和认知症状在多种与年龄相关的疾病中同时出现,如正常衰老,阿尔茨海默病(AD),和情绪障碍,如抑郁和焦虑。虽然这种关系背后复杂的相互作用仍然知之甚少,这篇文章强调了全长(TrkB.FL)和截断(TrkB。T1)神经营养系统中酪氨酸激酶受体TrkB的同工型可能显着影响与年龄相关的情绪和认知功能,通过改变脑源性神经营养因子(BDNF)信号,对神经元健康不可或缺,认知功能和情绪调节。虽然这种不平衡对发病机制的贡献有待完全阐明,这篇综述评估了其潜在的中介作用,将情绪和认知能力下降与年龄相关的疾病联系起来TrkB之间的相互作用。T1和TrkB。FL同种型可以被认为是这种复杂关系的关键共享调节剂。本综述旨在综合当前关于TrkB同工型失衡的知识,特别是它对年龄相关的认知能力下降和情绪障碍的贡献。通过检查衰老之间的共同致病途径,认知能力下降,和情绪障碍通过TrkB信号的镜头,这篇综述揭示了以前没有考虑过的潜在治疗靶点,为打击与年龄相关的心理健康问题以及认知缺陷提供了新的视角。
    Age-related cognitive and affective disorders pose significant public health challenges. Notably, emotional and cognitive symptoms co-occur across multiple age-associated conditions like normal aging, Alzheimer\'s disease (AD), and mood disorders such as depression and anxiety. While the intricate interplay underlying this relationship remains poorly understood, this article highlights the possibility that an imbalance between full-length (TrkB.FL) and truncated (TrkB.T1) isoforms of tyrosine kinase receptor TrkB in the neurotrophic system may significantly affect age-associated emotional and cognitive functions, by altering brain-derived neurotrophic factor (BDNF) signaling, integral to neuronal health, cognitive functions and mood regulation. While the contribution of this imbalance to pathogenesis awaits full elucidation, this review evaluates its potential mediating role, linking emotional and cognitive decline across age-related disorders The interplay between TrkB.T1 and TrkB.FL isoforms may be considered as a pivotal shared regulator underlying this complex relationship. The current review aims to synthesize current knowledge on TrkB isoform imbalance, specifically its contribution to age-related cognitive decline and mood disorders. By examining shared pathogenic pathways between aging, cognitive decline, and mood disorders through the lens of TrkB signaling, this review uncovers potential therapeutic targets not previously considered, offering a fresh perspective on combating age-related mental health issues as well as cognitive deficits.
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  • 文章类型: Journal Article
    β淀粉样蛋白PET扫描是一种微创生物标志物,可告知阿尔茨海默病(AD)的诊断。照顾者的反应和经验(CARE)研究,一个想法补充,旨在了解PET扫描接受者及其护理伙伴关于扫描动机的经验,报告和解释结果,以及结果的影响。同意加入CARE-IDEAS研究的轻度认知障碍或痴呆症患者及其护理伙伴在大约18个月后参加了基线调查和随访调查。辅以对参与者子集的深入定性访谈。接受扫描并自愿进行后续研究的患者更有可能是男性,受过更好的教育,收入高于一般人口。调查信息与医疗保险数据合并。本文整合了一些CARE-IDEAS出版物的发现,并为实践和研究提供了启示。尽管大多数参与者准确地报告了扫描结果,他们经常对预后的意义感到困惑.一些参与者报告了结果的困扰,但是测量的抑郁没有显著变化,负担,或者随着时间的推移经济压力。许多受访者希望获得有关预后和支持资源的更多信息。扫描结果与服务使用随时间的变化没有差异。研究结果表明,临床医生需要精心设计和测试的工具来讨论扫描及其结果的风险和益处。以及支持患者和护理合作伙伴后续规划的资源。扫描结果的学习提供了一个接触点,应利用该接触点来促进共享决策和以人为中心的纵向AD护理。
    Beta amyloid PET scans are a minimally invasive biomarker that may inform Alzheimer\'s disease (AD) diagnosis. The Caregiver\'s Reactions and Experience (CARE) study, an IDEAS supplement, aimed to understand experiences of PET scan recipients and their care partners regarding motivations for scans, reporting and interpreting results, and impact of results. Patients with mild cognitive impairment or dementia who agreed to join the CARE-IDEAS study and their care partners participated in a baseline survey and follow-up survey approximately 18 months later, supplemented by in-depth qualitative interviews with subsets of participants. Patients who received scans and volunteered for follow-up research were more likely to be male, better educated, and have higher income than the general population. Survey information was merged with Medicare data. This article integrates findings from several CARE-IDEAS publications and provides implications for practice and research. Although most participants accurately reported scan results, they were often confused about their meaning for prognosis. Some participants reported distress with results, but there were no significant changes in measured depression, burden, or economic strain over time. Many respondents desired more information about prognosis and supportive resources. Scan results were not differentially associated with changes in service use over time. Findings suggest a need for carefully designed and tested tools for clinicians to discuss risks and benefits of scans and their results, and resources to support patients and care partners in subsequent planning. Learning of scan results provides a point-of-contact that should be leveraged to facilitate shared decision-making and person-centered longitudinal AD care.
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