Differential roles of regional enlarged perivascular spaces in cognition and neuropsychiatric burden in drug-naive Parkinson’s disease
Han Kyu NaSuzy KimYongan SunYoung Joong YoonSeok Jong ChungChul Hyoung LyooYoung H. SohnPhil Hyu Lee
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Drug-naïve
Cognitive Decline
Abstract Objectives Subjective cognitive decline (SCD) is a known risk factor for Alzheimer’s disease. However, little research has examined whether healthy older adults with SCD (SCD+) exhibit lower cognition and increased rates of cognitive decline compared to those without SCD (SCD−). The goal of this study was to examine if cognitive change over a 15-year period differs between SCD+ and SCD−. Method 3,019 cognitively normal older adults (831 SCD+) from 3 Rush Alzheimer’s Disease Center cohort studies were followed annually for up to a maximum of 15 years. Due to attrition, the average follow-up time was 5.7 years. Cognition was measured using z-scores of global cognition, episodic memory, semantic memory, perceptual speed, visuospatial ability, and working memory. Linear mixed-effects models investigated whether SCD was associated with cognitive change. Results Both baseline cognition and cognitive change over time differed between SCD+ and SCD−. People with SCD+ exhibited lower baseline scores and a steeper decline in global cognition, episodic memory, semantic memory, and perceptual speed. People with SCD+ did not differ from SCD− in baseline visuospatial ability or working memory but exhibited increased change over time in those two domains compared to SCD−. Discussion The observed results reveal that older adults with SCD+ have lower baseline cognition and steeper declines in cognition over time compared to SCD−. Older adults with SCD may be aware of subtle cognitive declines that occur over time in global cognition, episodic memory, semantic memory, perceptual speed, visuospatial ability, and working memory compared to those without SCD.
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Cognitive Decline
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Objective: To characterize the predictors of potential drug-drug interactions among adult diabetic hypertensive outpatients at Kenyatta National Hospital.
Methods: This cross-sectional study collected and analyzed data on potential drug interactions from 104 diabetic hypertensive outpatients (aged ≥18 y) at the Department of Endocrinology Outpatient Clinic of Kenyatta National Hospital from 1st May 2019 to 31st August 2019. The main outcome measure was the prevalence of potential drug-drug interactions and their predictors among the study population.
Results: There was a female preponderance (70.2%). The mean age of the study participants was 61.6 y (SD±10.8). The prevalence of potential drug interactions was high at 57.7%. The average number of drug interactions was one interacting pair per patient, with a majority of the prescriptions (81.0%) having moderate drug-drug interactions. Patients receiving>2 drugs were almost three times more likely to have drug-drug interaction compared to those prescribed ≤ 2 drugs (AOR=2.79; 95% CI: 1.11-7.28); p=0.029). Participants who were at stage 4 of hypertension were 2.5 times more likely to have a drug-drug interaction compared to the other stages of hypertension (AOR=2.52; 95% CI 1.31-4.89; p=0.007).
Conclusion: Polypharmacy and stage 4 hypertension are independently associated with drug-drug interactions among patients with both diabetes and hypertension. Future studies should characterize the specific type of drug interactions and possible targets of minimization of drug-drug interactions.
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Background:Clinical research has demonstrated that brain reserve (BR) could exert positive effects on cognition for patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, the effects of BR on cognition in individuals with subjective cognitive decline (SCD) are not clea r. Objective:To examine cross-sectional effects of BR on cognition in SCD populations. Methods:One hundred forty-nine subjects were studied from the Sino Longitudinal Study on Cognitive Decline (SILCODE) study. Head circumference was used as a proxy of BR. Cognition was assessed across four domains (memory, executive, language, and general cognitive functions). Multiple linear regression models were conducted to examine effects of BR on cognitive scores. Furthermore, we addressed the question that whether the degree of self-perception of cognitive decline modified the effect of BR on cognitive performance in SCD subjects. Results:We found a positive effect of BR on language cognition in subjects with SCD. Furthermore, the positive effect of BR on language cognition survived in SCD participants with a low degree of self-perception of cognitive decline while disappeared in SCD participants with a high degree of self-perception of cognitive decline. Conclusion:This study suggests that BR has the potential to delay or slow down cognitive decline in SCD individuals, especially for mild SCD.
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This paper reviews different methodological approaches taken to examine terminal decline in cognitive function, and presents new findings from the Bronx Aging Study (BAS). Numerous approaches have been taken to assess mortality effects on cognition: comparing survivors and decedents level and rate of change in cognition, and identifying individual differences in cognition associated with time-to-death. However, few studies have actually modeled within-person change in cognition as a function of time-to-death. Using linear mixed models with a change point, intraindividual change in episodic memory was modeled as a function of both age and time-to-death. A dramatic increase in the rate of decline was identified at 8.4 years prior to death, providing clear evidence of a terminal-decline phase that is much longer than previously estimated. These results emphasize the importance of modeling the time course and effects of terminal cognitive decline for understanding cognitive change in aging adults.
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With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.
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Background Study of the correlation between uric acid (UA) and depression will help to establish evidence for, or against, the new hypothesis stating that the activation of inflammatory, oxidative, and nitrosative stress pathways is a key pathophysiological factor in depression, and reduced antioxidant reserve may coexist with the increased consumption of UA as a scavenger.Objective The aim of this study was to investigate whether serum UA levels are different between drug-naive depressed patients and healthy controls and to compare UA levels in those depressed patients before and after treatment.Materials and methods The serum UA levels and Hamilton Depression Rating Scale scores were estimated in 120 patients with major depressive disorder before and after 5 weeks of treatment with antidepressants. In addition, serum UA levels were measured in 120 healthy controls.Results Drug-naive depressed patients had significantly lower UA levels (3.8±0.93 mg/dl) than the healthy control group (4.57±0.83 mg/dl, P<0.001). We also found that the UA levels of depressive patients increased significantly after 5 weeks of treatment with antidepressants.Conclusion This study presents further proof of the involvement of UA in the pathogenesis and treatment of depression.
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Depression
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Free radical scavenger
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Abstract There is variability in cognitive aging between individuals. This study aimed to investigate cognitive aging trajectories, the associated modifiable factors, and the association of these trajectories with dementia. Community-dwelling older adults (n=19,114) without dementia or major cognitive impairment at inclusion were followed for up to 7 years, with regular standardized cognitive assessments. Group-based (multi-) trajectory modeling identified distinct cognitive trajectories. Structural equation modeling (n=16,018) was used to analyze the associated predictors. Four to seven trajectories were identified per cognitive domain, with generally stable trajectories. Improvement in verbal fluency and minor psychomotor slowing were common. Substantial decline in global cognition and episodic memory were observed in a small proportion of individuals. The highest proportions of dementia cases were in trajectories with major decline in global cognition (56.9%) and memory (33.2%). A number of sociodemographic characteristics, health behaviors and chronic conditions were either directly or indirectly associated with cognitive change in older adults. This study found that some individuals appear resilient to cognitive decline even with advancing age, and that factors that promote healthy cognitive aging are not simply the absence of factors which confer risk for decline.
Cognitive Decline
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Cognitive aging
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