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Homocysteine and Cognitive Impairment in Thai Elderly  [PDF]
Duangkamol Viroonudomphol, Saowanee Kajanachumpol, Chaiwat Prawettongsopon
World Journal of Engineering and Technology (WJET) , 2016, DOI: 10.4236/wjet.2016.44054
Abstract: Background: The prevalence and incidence of dementia increase dramatically with age. Cognitive impairment is one major symptom of dementia. Older persons increase in our society, which means a big number of people with decreased cognitive function. So it is important to find out risk factors. The amino acid homocysteine may be a risk factor. Objective: The aim was to determine the independent association of homocysteine and cognitive performance in Thai elderly. Design: Concentrations of homocysteine were measured in fasting blood samples of 100 Thais aged 60 - 80 years. Global cognitive function was assessed by using with mini-Mental State Examination score (MMSE), and cognitive functions were assessed by a neuropsychological test battery. The relationship between homocysteine levels and neuropsychological test scores was assessed by multiple linear regression. Results: In the crude model, homocysteine was inversely associated with scores for learning slope test (B = ?0.048, p = 0.042) and verbal pair total test (B = ?0.124, p = 0.032). After adjusting for confounders, no association was found between homocysteine and cognitive impairment. Age (B = ?0.129, p = 0.007) was found to be a significant determinant of decreased learning slope score. Similarly, age (B = ?0.298, p = 0.009) and education (B = 0.267, p = 0.029) were found to be significant determinants of decreased verbal pair total score. Conclusions: In this study, it was found that no association between homocysteine and cognitive impairment in a population of institutionalized subjects. Age and education were more significantly associated with cognitive impairment scores than homocysteine.
Detection of cognitive impairment in the elderly by general internists in Brazil
Jacinto, Alessandro Ferrari;Brucki, Sonia;Porto, Cláudia Sellitto;Martins, Milton de Arruda;Nitrini, Ricardo;
Clinics , 2011, DOI: 10.1590/S1807-59322011000800012
Abstract: background: cognitive impairment, from mild forms to dementia, is an important social and health concern, principally among older individuals. elderly patients are usually followed by general internists, who may overlook this condition. objective: our aim was to determine whether cognitive impairment diagnosed by specialists had been previously detected by general internists. subjects and methods: a total of 248 elderly individuals randomly selected from a list of outpatients seen by general internists in a public university hospital in s?o paulo, brazil, were evaluated by a geriatrician. patients were then classified as having probable cognitive impairment or not, based on their performance on the mini-mental state examination and the informant questionnaire on cognitive decline in the elderly. cases of probable impairment were submitted to routine laboratory investigation, brain computed tomography, and neuropsychological evaluation. the final diagnoses were established by a consensus panel comprising two neurologists and the geriatrician who evaluated the patients using all available data. general internists' files for all cognitively impaired cases and for a selected sample of individuals without cognitive impairment were checked for any record of cognitive complaints or decline. results: forty-three patients were classified as demented (n = 21) or as cognitively impaired but not demented (n = 22). the evaluation of the general internists' files revealed that information on cognitive complaints or decline was recorded for seven (16.3%) of the 43 patients with dementia or cognitive impairment without dementia. conclusions: general internists seldom detected cognitive decline in elderly patients in brazil. further studies should be conducted to elucidate the reasons for this low rate of detection.
Socio-demographic and health-related factors associated with cognitive impairment in the elderly in Taiwan
Ming-Shiang Wu, Tsuo-Hung Lan, Chun-Min Chen, Herng-Chia Chiu, Tzuo-Yun Lan
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-22
Abstract: We analysed data from 2119 persons aged 65 years and over who participated in the 2005 National Health Interview Survey. Cognitive impairment was defined as having the score of the Mini Mental State Examination lower than 24. The χ2 test and multiple logistic regression models were used to evaluate the association between cognitive impairment and variables of socio-demography, chronic diseases, geriatric conditions, lifestyle, and dietary factors.The prevalence of cognitive impairment was 22.2%. Results of multivariate analysis indicated that low education, being single, low social support, lower lipid level, history of stroke, physical inactivity, non-coffee drinking and poor physical function were associated with a higher risk of cognitive impairment.Most of the characteristics in relation to cognitive impairment identified in our analysis are potentially modifiable. These results suggest that improving lifestyle behaviours such as regular exercise and increased social participation could help prevent or decrease the risk of cognitive impairment. Further investigations using longitudinal data are needed to clarify our findings.The older population is rapidly growing throughout the world. By 2020 it is estimated that the elderly will exceed 1 billion, and 700 million of them will be in the developing countries [1]. As for other developing or newly developed countries, Taiwan is facing the problem of population aging. The proportion of people aged 65 years and over in Taiwan reached 7% in 1993, the WHO benchmark of an aged nation. Currently the percentage of older population has increased to 11% and is projected to hit 14% by 2018 [2].The increasing number of the older people has imposed a huge health impact on the society, as longer survival is also accompanied by the greater decline in health and different domains of function [3]. For the cognitive function, evidence from previous studies has indicated that cognitive function begins to decline from the age of 50 a
Hyperhomocysteinemia in Patients with Cognitive Impairment
Marcello Ciaccio,Giulia Bivona,Antonino Tuttolomondo,Chiara Bellia,Riccardo Di Sciacca,Gaia Chiarello,Bruna Lo Sasso,Rosa C. Carollo,Domenico Di Raimondo,Antonio Pinto,Giuseppe Licata
Research Journal of Biological Sciences , 2012,
Abstract: Cognitive impairment is common in elderly people and represents clinical feature of neurodegenerative diseases. Not all of patients with Mild Cognitive Impairment (MCI) finally develop dementia and it is interesting to investigate the role of possible markers for early diagnosis. Hyperhomocysteinemia is associated to several pathologies including cognitive impairment; aim of this study is to evaluate the correlation between cognitive performance assessment and homocysteine plasma levels. Total 74 patients and 75 healthy controls were enrolled and MCI were defined by a MMSE score lower than 26 after adjustment for years of schooling. Homocysteine plasma levels were determined. Homocysteine levels significantly raised in patients with cognitive impairment and showed a significant negative association with MMSE score. Finally, our data show that a moderate risk of cognitive impairment could be associated to high homocysteine plasma levels.
Hyperhomocysteinemia in Patients with Cognitive Impairment
Marcello Ciaccio,Giulia Bivona,Antonino Tuttolomondo,Chiara Bellia
Research Journal of Biological Sciences , 2008,
Abstract: Cognitive impairment is common in elderly people and represents clinical feature of neurodegenerative diseases. Not all of patients with Mild Cognitive Impairment (MCI) finally develop dementia and it is interesting to investigate the role of possible markers for early diagnosis. Hyperhomocysteinemia is associated to several pathologies including cognitive impairment; aim of this study is to evaluate the correlation between cognitive performance assessment and homocysteine plasma levels. Total 74 patients and 75 healthy controls were enrolled and MCI were defined by a MMSE score lower than 26 after adjustment for years of schooling. Homocysteine plasma levels were determined. Homocysteine levels significantly raised in patients with cognitive impairment and showed a significant negative association with MMSE score. Finally, our data show that a moderate risk of cognitive impairment could be associated to high homocysteine plasma levels.
Measuring the Cognitive Impact of Laughter on Elderly People with Mild Cognitive Impairment in Japan  [PDF]
Miwa Yamamoto, Shizue Mizuno, Masako Aota, Yoko Murakami
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.36084
Abstract: Objective: To evaluate the effect of laughter on cognition in elderly with mild cognitive impairment (MCI) through an appropriately designed intervention. Methods: The intervention involved watching a Japanese comedy routine (Manzai) for approximately twenty minutes, once a week for ten weeks. Participants were asked to paint, as a simple exercise, in addition to watching the show. Twenty-seven patients with MCI from the convalescent ward of a general hospital in the Kansai region of Japan. We measured cognition by evaluating five cognitive function domains before (baseline) and after the intervention. We used the Wilcoxon signed rank test, a distribution-free method, to compare baseline and post-intervention data. Ethical Consideration: Participants were given a document explaining the study. Only those who officially agreed to participate were enrolled. Results: Mean age of patients was 85.0 ± 2.8 years; average education was 8.6 ± 2.8 years. Three cognitive function domains had significantly different average scores after the intervention: 1) Exercise: 44.4 ± 8.9 points at baseline, 36.3 ± 10.2 post-intervention (p = 0.014); 2) Word memory: 40.6 ± 7.2 at baseline, 43.1 ± 8.8 post-intervention (p = 0.002); and 3) Animal name recollection: 35.3 ± 8.4 at baseline, 38.1 ± 9.0 post-intervention (p = 0.003). Discussion: The intervention led to significantly higher cognitive scores in exercise, word memory, and animal name recollection domains, suggesting that interventions focused on laughter and simple exercise may improve cognition in elderly patients with MCI.
Aggressive behavior, cognitive impairment, and depressive symptoms in elderly subjects  [cached]
Margari F,Sicolo M,Spinelli L,Mastroianni F
Neuropsychiatric Disease and Treatment , 2012,
Abstract: Francesco Margari,1 Michele Sicolo,1 Lucia Spinelli,1 Franco Mastroianni,2 Adriana Pastore,1 Francesco Craig,3 Maria Giuseppina Petruzzelli31Psychiatry Unit, Department of Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of Bari “Aldo Moro”, 2Geriatrics Unit, Hospital “Miulli”, Acquaviva delle Fonti; 3Child Neuropsychiatry Unit, Department of Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, ItalyAbstract: Patients with dementia often have neuropsychiatric symptoms. The objective of this study was to evaluate the relationship between neuropsychiatric symptoms and progressive cognitive decline by assessing cognitive impairment, depressive symptoms, and aggressive behavior in a sample of elderly subjects. The study sample consisted of 201 subjects admitted to nursing homes. For the purpose of the present study each subject was evaluated using the Mini-Mental State Examination, the Geriatric Depression Scale, and the Modified Overt Aggression Scale. The results show that aggressive behavior and depressive symptoms are associated with progressive cognitive decline in elderly subjects. Early assessment of these conditions can promote rational therapeutic strategies that may improve the quality of life and delay institutionalization for elderly patients.Keywords: neuropsychiatric symptoms, dementia, behavioral and psychological syndromes of dementia (BPSD), progressive cognitive decline
Effects of Tai Chi Chuan on cognition of elderly women with mild cognitive impairment
Juliana Yumi Tizon Kasai,Alexandre Leopold Busse,Regina Miksian Magaldi,Maria Angela Soci
Einstein (S?o Paulo) , 2010,
Abstract: Objective: To detect the effects of Tai Chi Chuan practice on the cognition of elderly subjects with Mild Cognitive Impairment. Methods: This is a pilot study with 26 elderly patients (mean age of 74 years) with Mild Cognitive Impairment. The evaluation instruments were Subjective Memory Complaint Scale (SMC), Rivermead Behavioral Memory Test (RBMT) and Digit Span Forward and Backward (DSF and DSB) from the Wechsler Adult Intelligence Scale (WAIS). One group of 13 patients received two weekly 60-minute classes of Tai Chi Chuan (Yang style) for 6 consecutive months, and the rest formed the Control Group. The Tai Chi Chuan Group was also evaluated as to learning of the Tai Chi Chuan practical exercises by means of a Specific Learning Test applied after three months of intervention. Results: After six months of intervention, the TCC Group showed significant improvement on the RBMT and the SMC (p = 0.007 and p = 0.023, respectively). The Control Group showed no significant differences in the cognitive tests during the study. There was a significant correlation between the Tai Chi Chuan Learning Test and RBMT (p = 0.008), showing that patients with a better performance in exercising TCC also showed a better performance in memory. Conclusions: In this study, a six-month program of Tai Chi Chuan afforded a significant improvement of the performance of memory complaints in the elderly with Mild Cognitive Impairment. Additional randomized studies with larger samples and more prolonged follow-up are needed to confirm these benefits.
Aggressive behavior, cognitive impairment, and depressive symptoms in elderly subjects
Margari F, Sicolo M, Spinelli L, Mastroianni F, Pastore A, Craig F, Petruzzelli MG
Neuropsychiatric Disease and Treatment , 2012, DOI: http://dx.doi.org/10.2147/NDT.S33745
Abstract: ggressive behavior, cognitive impairment, and depressive symptoms in elderly subjects Original Research (17250) Total Article Views Authors: Margari F, Sicolo M, Spinelli L, Mastroianni F, Pastore A, Craig F, Petruzzelli MG Published Date August 2012 Volume 2012:8 Pages 347 - 353 DOI: http://dx.doi.org/10.2147/NDT.S33745 Received: 09 May 2012 Accepted: 12 June 2012 Published: 01 August 2012 Francesco Margari,1 Michele Sicolo,1 Lucia Spinelli,1 Franco Mastroianni,2 Adriana Pastore,1 Francesco Craig,3 Maria Giuseppina Petruzzelli3 1Psychiatry Unit, Department of Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of Bari “Aldo Moro”, 2Geriatrics Unit, Hospital “Miulli”, Acquaviva delle Fonti; 3Child Neuropsychiatry Unit, Department of Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy Abstract: Patients with dementia often have neuropsychiatric symptoms. The objective of this study was to evaluate the relationship between neuropsychiatric symptoms and progressive cognitive decline by assessing cognitive impairment, depressive symptoms, and aggressive behavior in a sample of elderly subjects. The study sample consisted of 201 subjects admitted to nursing homes. For the purpose of the present study each subject was evaluated using the Mini-Mental State Examination, the Geriatric Depression Scale, and the Modified Overt Aggression Scale. The results show that aggressive behavior and depressive symptoms are associated with progressive cognitive decline in elderly subjects. Early assessment of these conditions can promote rational therapeutic strategies that may improve the quality of life and delay institutionalization for elderly patients.
Combining cognitive screening tests for the evaluation of mild cognitive impairment in the elderly
Ladeira, Rodolfo B.;Diniz, Breno S.;Nunes, Paula V.;Forlenza, Orestes V.;
Clinics , 2009, DOI: 10.1590/S1807-59322009001000006
Abstract: objective: to determine the accuracy of the mini-mental state examination combined with the verbal fluency test and clock drawing test for the identification of patients with mild cognitive impairment and alzheimer's disease (ad). method: these tests were used to evaluate cognitive function in 247 older adults. subjects were divided into three groups according to their cognitive state: mild cognitive impairment (n=83), ad (n=81), cognitively unimpaired controls (n=83), based on clinical and neuropsychological data. the diagnostic accuracy of each test for discriminating between these diagnostic groups (mild cognitive impairment or ad vs. controls) was examined with the aid of receiver operating characteristic (roc) curves. additionally, we evaluated the benefit of the combination of tests on diagnostic accuracy. results: although they were accurate enough for the identification of alzheimer's disease, neither test alone proved adequate for the correct separation of patients with mild cognitive impairment from healthy subjects. combining these tests did not improve diagnostic accuracy, as compared to the mini-mental state examination alone, in the identification of patients with mild cognitive impairment or alzheimer's disease. conclusions: the present data do not warrant the combined use of the mini-mental state examination, the verbal fluency test and the clock drawing test as a sufficient diagnostic schedule in screening for mild cognitive impairment. the present data do not support the notion that the combination of test scores is better that the use of mini-mental state examination scores alone in the screening for alzheimer's disease.
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