فهرست مطالب maryam noroozian

With the increasing proportion of the elderly population, neurodegenerative diseases such as dementia are becoming more prevalent worldwide. Vascular risk factors are considered significant targets for cognitive decline prevention. We reviewed the effect of cardiovascular risk factors on cognitive decline prevention in the elderly to evaluate the quantity and quality of evidence in managing the elderly population with cognitive decline. Data analysis was available from 25 studies that explored the effects of controlling cardiovascular risk factors on the risk of cognitive impairment. These risk factors include diabetes mellitus, high blood pressure, high cholesterol levels, and exercise and physical activity. The most positive evidence was found for exercise and physical activity. On the other hand, diabetes mellitus and cholesterol modifications showed no positive impact on cognitive function. Studies on hypertension control were incongruous. There is a need for large-sample, robust randomized clinical trials to provide sufficient evidence for the modification of various cardiovascular risk factors in preventing cognitive decline.

According to the prediction of WHO and the analysis of demographic statistics, the aging phenomenon is considered one of the upcoming challenges for the Iranian society. Therefore, moving in the direction of successful aging is considered a necessity. Hence, the purpose of this research is to phenomenologically explain the successful aging in men based on their lived experiences. This research was a qualitative study, of descriptive phenomenology type using a thematic analysis technique. The research population included all older men over 60 years old living in Tehran and Karaj, Iran, among whom 18 successful older people were selected as a sample using a purposeful sampling method until theoretical saturation was reached. The data were collected using in-depth and semi-structured interviews, and the seven-step Colaizzi method was used for their analysis. The findings from the interviews were extracted and classified into five main themes (individual characteristics, social characteristics, family characteristics, self-care, and feelings of support) and 21 sub-themes. The results of this research illustrated that the successful older adults possess personal characteristics such as responsibility, commitment, patience, flexibility, sociability, purposefulness, capability and independence. Moreover, they are socially effective, socially accepted and do not feel lonely emotionally, have warm family relationships, are under the financial support of the family, have physical, spiritual, and mental self-care, feel that they are supported by the society and the government, and are also supported economically and in terms of health services. According to the results of the research, it can be concluded that physical, spiritual, mental, and psychological self-care should be taken seriously in order to have a successful aging, and there should be economic, social, and medical support for older people.

This study aimed to investigate neurocognitive functioning, quality of life, and global functional performance in Ultra-High Risk (UHR) individuals compared to Familial High-Risk (FHR) individuals for developing schizophrenia.

An observational cross-sectional study was conducted using a convenient sampling method at Roozbeh Hospital in Tehran, Iran, from June 2017 to January 2020. The study included 40 UHR individuals based on the Structured Interview for Psychosis Syndrome (SIPS) interview, as well as 34 FHR individuals due to genetic risk. Neurocognitive functioning, quality of life, and global functional performance were assessed by using the Cambridge Automated Neuropsychological Test Battery (CANTAB) and Controlled Oral Word Association Test (COWAT), Quality of Life Scale (QLS), and Global Assessment of Functioning (GAF).

UHR individuals for schizophrenia demonstrated significant lower scores in phonemic and semantic verbal fluency (t = 6.218, P < 0.001; t = 4.184, P < 0.001, respectively), more total errors for spatial working memory (t = -5.874, P < 0.001), and fewer problems solved in minimum moves in Stocking of Cambridge (SOC) (t = -2.706, P < 0.01) compared to FHR individuals. Intra-Extra Dimension (IED) did not differ significantly between the two groups. Moreover, the study indicated significant GAF decline (F = 79.257, P < 0.001) and lower total score on the QLS (t = -10.655, P < 0.001) in UHR compared to FHR individuals.

It is possible to differentiate UHR individuals from FHR individuals through neurocognitive, quality of life, and global functioning assessment.

This study aimed to compare the diagnostic value of four questionnaires for the diagnosis of neurocognitive disorders (NCDs) in the elderly.

 In this project, people older than 60 years who lived in Tehran were investigated. A total of 99 literate cases were enrolled in the study, and four questionnaires, including functional assessment staging tool (FAST), abbreviated mental test score (AMTS), mini-mental state examination (MMSE), and modified Persian test of elderly for assessment of cognition and executive function (PEACE) were completed for them. They were then referred to a neuropsychiatrist, and the status of their cognition and neurobehavior was determined. The specialists were blinded to the results of the tests.

Of the 99 participants studied, 39 cases were healthy, eight cases had mild Alzheimer’s disease, 38 had amnesic MCI, five cases had secondary dementia, and nine cases had mixed vascular dementia and Alzheimer’s disease. The area under the ROC curve for distinguishing the healthy group from the rest of the population was 0.692, 0.629, 0.734, and 0.751 for the FAST, AMTS, MMSE, and NBCSS questionnaires, respectively.

MMSE and NBCSS tests had better diagnostic power than the other two tests to distinguish the healthy group from the rest of the population.

This study aimed to assess the efficacy of an herbal formulation based on Boswellia sacra in improving cognitive and behavioral symptoms in patients with mild cognitive impairment (MCI) and mild‑to‑moderate stages of Alzheimer’s disease (AD).

A 3‑month, parallel‑group, placebo‑controlled trial was implemented from October 2021 to April 2022. Patients with MCI and mild‑to‑moderate stages of AD aged above 50 years (n = 60; 40 women, 20 men) enrolled in the study using clinical diagnosis and a score of 10–30 on the mini‑mental state examination (MMSE) test. They were assigned into two groups; one receiving a herbal formulation) include B. sacra, Melissa officinalis, Piper longum, Cinnamomum verum, and Physalis alkekengi) three times a day and the other receiving a placebo for 3 months. The main efficacy measures were the changes in cognitive domains based on the MMSE and changes in behavioral and psychiatric symptoms based on neuropsychiatric inventory (NPI) scores compared with baseline. Side effects were also recorded.

Results of this study showed significant differences between the two groups after 3 months in terms of all the assessed variables, including the overall result of the mean score of MMSE and NPI tests (P ≤ 0.001). The herbal formulation had the most considerable effects on the domains of orientation, attention, working memory, delay recall, and language of the MMSE test.

Herbal formulation based on B. sacra was significantly effective compared to a placebo in improving cognitive and behavioral symptoms in patients with MCI and mild‑to‑moderate AD.

 Dysregulation of long-term expression of non-coding RNAs (lncRNAs) has a potential role in progressive brain disorders such as Alzheimer's disease. This study aimed to analyze the apoptosis and expression of 51A and NAT-Rad18 lncRNAs and their target genes in brain tissue and peripheral blood mononuclear cells (PBMCs) of the rat model of AD, before and after memantine treatment.

 Twenty-eight male Wistar rats were divided into four groups: 1. Normal control (n = 4), 2. Sham-operated (n = 4), 3. Alzheimer's control (n = 10), and 4. The experimental group (n = 10) was treated with memantine. The qPCR and TUNEL tests were used to detect the lncRNAs expression and apoptosis.

 Sorl1 gene was reduced in brain tissue of Alzheimer’s control (p = 0.016) and PBMCs of Alzheimer's control and experimental groups (p = 0.002 and p = 0.001 respectively). The expression of NAT-Rad18 and Rad18 genes increased in brain tissue of Alzheimer's control group (p = 0.002 and p = 0.04 respectively) while reduced in PBMCs of Alzheimer's control and experimental groups (p = 0.005 and p = 0.045 for NAT-Rad18, p = 0.01 and p = 0.006 for Rad18).

 ROC curve analysis showed 100% sensitivity and 85.7% specificity for the Sorl1 gene with 0.911 under the curve area and 100% sensitivity and 100% specificity for NAT-Rad18 and Rad18, separately with one under the curve area. Decreased expression in Sorl1, NAT-Rad18, and Rad18 genes can be used as blood biomarkers for diagnosis independently. However, studies on Alzheimer's patients are needed.

Learning is the process of acquiring the new information, and the outcome of learning is memory. Memory is the ability to store, retain, and retrieve information that activates past experiences to influence today's behavior. Researchers have studied the important role of two basic dimensions of emotion, namely arousal and capacity, in the memory of emotional events. The aim of this study was to answer the questions of whether the emotional lexical content of sentences or the tone of emotional speech prosody is effective in evoking the memory of patients with Alzheimer disease. Does the interaction of the two play a greater role in better recovering the memory of these patients? For this purpose, from 40 patients with mild to moderate Alzheimer disease, a test was performed using the Persian ESD emotional language database to assess the degree of memory arousal. The results showed that emotional lexical content along with emotional speech prosody is effective in retrieving, recalling and sustaining emotional sentences. The effect of emotional speech prosody on words primarily causes emotional arousal to increase clarity and clearly of memory, and secondly causes emotional words to form a conceptual group or conceptual cohesion. Therefore, they should be retrieve better.

One of the research topics that influenced by gender differences is the issue of emotion production and perception. Numerous studies have shown that women and men differ in their perception of facial expressions, watching movies, listening to music, and ultimately understanding emotional prosody, or how women and men produce their emotions in contextual situations. The aim of this study was to investigate the effect of emotional prosody as a non-verbal communication tool against emotional lexical content on the elderly over 65 years (as a control group) and Alzheimer's patients in mild to moderate levels separately for men and women. In the group of Alzheimer's patients (n = 12), in the emotion of anger and fear, women were perceived more than men this emotion with emotional prosody, but in the emotions of happiness, sadness and disgust, men used more emotional prosody and women unlike, used more lexical content to understand these emotions. While in the control group (12 people), women used the lexical content to understand all the emotions and emotional prosody had no effect on the comprehension. In the emotion of sadness, both men and women used only lexical content in comprehension, and emotional prosody was ineffective. Men used emotional prosody in disgust more than just other emotions, but the lexical content was more effective in understanding other emotions. Therefore, men and women react differently depending on the type of emotion, and this difference depends on biological factors as well as relationships and social skills of individuals. Because by experiencing and evaluating life events, different emotions are perceived.

A powerful imaging method for evaluating brain patches is resting-state functional magnetic resonance imaging, in which the subject is at rest. Artificial neural networks are one of the several Alzheimer's disease analysis and diagnosis methods which is used in this study. We investigate artificial neural networks' ability to diagnose Alzheimer's disease using resting-state functional magnetic resonance imaging data.

Functional and structural magnetic resonance imaging data acquisition was applied for 15 Alzheimer’s disease, 17 mild cognitive impaired, and ten normal healthy participants. Time series of blood oxygen level dependent extracted from the multi subject dictionary learning brain atlas after pre-processing. This study develops a one-dimensional convolutional neural network using extracted signals of the functional atlas for differential diagnosis of Alzheimer's disease.

Applying the proposed method to resting-state functional magnetic resonance imaging signals for classifying three classes of Alzheimer's disease patients resulted in overall accuracy, F1-score, and precision of 0.685 ,0.663, and 0.681 respectively. Using 39 regions in the brain and proposing a quiet simple network than most of the available deep learning-based methods are the main advantages of this model.

Resting-state functional magnetic resonance imaging signal recognition based on a functional atlas with the application of a deep neural network has a pattern recognition capability that can make a differential diagnosis with an acceptable level of accuracy and precision. Therefore, deep neural networks can be considered as a tool for the early diagnosis of Alzheimer’s disease.

Emotion plays an important role in the daily life of humans from birth to death. In the cognitive social theories it suggests that emotion regulating and understanding ability increases in aging, because of optimal increase of positive state and increasing skill in understanding the emotional cues of word meanings. The purpose of this article is the study of how is understood emotion in older adults? Do the emotions convey through the lexical meanings of quoted sentences or emotional prosody? Therefore understanding of the basic emotions including anger, disgust, fear, happiness, sadness and neutral situation through emotional prosody study in old age(up 65 years old), young and middle age. The aim is that how emotional lexical content without prosody is understood and how is the interaction of these two modes. Based on the observations of this research, the elderly use the meanings of the emotional content for understanding of sentences, instead of emotional prosody. Unlike old ages, young and mid old ages understand emotional sentences through emotional prosody and the meanings of emotional content is in second priority.

Previous studies indicated that intensity level might be a determining factor in the beneficial or adverse effects of exercise on spatial memory. As intensive exercise appears to deteriorate learning and memory and recent reports have suggested that one-night sleep deprivation improves mood and neurogenesis in depressed patients for at least one day. The present study was designed to investigate the effect of REM sleep deprivation (REM-SD) on memory impairment induced by intense exercise. Animals had undergone an intense protocol (speed: 18 m/min and no tilt for the first week, the duration and treadmill tilt were increased progressively, 10 minutes and five degrees increased in each week) of treadmill for five days a week for five weeks then deprived of sleep for 24 hours using the water-filled multiple platforms. The level of mammalian Target of Rapamycin (mTOR) in the hippocampus and the prefrontal cortex (PFC) was assessed by Western blotting. Five weeks of intensive exercise and 24h REM-SD were decreased the level of mTOR expression; 24h REM-SD improved intensive exercise-associated decreases in the basal levels of mTOR. The present data suggested that REM-SD might be considered as a compensatory factor for a short time. In addition, increasing in the mTOR level could improve memory impairment-induced by intensive exercise

Studies related to decision-making and choice preference in substance use behavior have less commonly focused on decision-making processes per se. Those processes include decision-making time, task-based complexity, and decision-making strategies.

The objectives of this study was the production of a culturallymodified version of theMouselab tool formeasurement of decision-making processes and to measure differences between decision-making processes in subjects with a positive and negative history of substance use.

Applying a snowball method for sampling, two groups, of individuals with a positive and negative history of substance use were recruited. The case and control groups consisted of 17 males with the mean age of 35.94 (± 12) and 33.8 (± 8.83) years, respectively. The measurement tool was a modified version of Mouselab computer game.

Using repeated measurement analysis of variances ant t-test with non-paired groups for comparing the case and control groups, it was found that the group with a positive history of substance use had a longer time-lapse in the decision-making process (P = 0.029). The accuracy of choice, however, was not different between the groups (P = 0.172).

Subjects with a positive history of substance use were different in two stages of decision-making process, which are dependent on the ecology and conditions of decision-making process, namely, search for information and decision-making. Two other stages of decision-making process that were dependent on individual cognitive and logical properties, i.e., stop search and choice, were not different in subjects with a positive history of substance use compared to the control group. Although subjects with a positive history of substance use consumed more resources for decision-making, their accuracy of choice was not different from the control group, thereby, ruling out a decision-making-related cognitive deficit.

A prominent challenge in modeling choice is specification of the underlying cognitive processes. Many cognitive-based models of decision-making draw substantially on algorithmic models of artificial intelligence and thus rely on associated metaphors of this field. In contrast, the current study avoids metaphors and aims at a first-hand identification of the behavioral elements of a process of choice. We designed a game in Mouselab resembling the real-world procedure of choosing a wife. 17 male subjects were exposed to cost-benefit decision criteria that closely mimic their societal respective conditions. The quality of choice index was measured with respect to its sensitivity to the final outcomes as well as process tracing of decisions. The correlation between this index and individual components of process tracing are discussed in detail. The choice quality index can be configured as a function of expected value and utility. In our sample the quality of choice with an average of 75.98% (SD: ±12.67) suggests that subjects obtained close to 76% of their expected gains. The quality of choice index, therefore, may be used for comparison of different conditions where the variables of decision-making are altered. The analysis of results also reveals that the cost of incorrect choice is significantly correlated with expected value (0.596, sig = 0.012) but not with utility. This means that when sub-jects face higher costs prior to making a decision, there exists a corresponding higher expectation of gains, i.e., higher expected value.

Thememory impairment screen (MIS) test is a brief, four-item, delay-free, andcued-recall test of memory impairment. It is highly correlated with Alzheimer’s pathology and can be easily used by trained non-specialists. However, the application of this test might be restricted due to minimum literacy levels requirement. The picture based MIS (PMIS) is a modified version that can be used by even illiterate or low-education people. The pictures can be adapted based on cultural differences. The aim of this study was to provide and validate the Persian version of illustrated memory impairment screen (PIMIS) test in elderly patients with Alzheimer’s disease in Iran. This validation was a cross-sectional study on people 60 years of age and older with different levels of education (illiterate to > 13 years of education). The participants consisted of subjects with normal cognition, subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and different types of Dementia. Cognitive impairment was diagnosed by a neurologist with expertise in dementia (gold standard). The validity was assessed by comparing MISIP with the gold standard. Area under ROC curve, optimal cut-point, sensitivity, specificity, and Cronbach’s alpha were estimated. Data were collected from 119 participants, 38 of which were diagnosed with Dementia, 17 with MCI, 21 with SCI and also 43 had normal cognition. The PIMIS score was significantly lower in patients diagnosed with dementia compared to the other groups (7.1 versus 4.3 for PIMIS score with a P value of less than 0.001). The PIMIS had a sensitivity of 60% and specificity of 91% for detecting dementia at a cut-point of five. Level of education had no significant effect on the test. IMIS is a simple reliable screening test in elderly population with variable literacy rates.

The brief version of community screening instrument for dementia (CSI-D) is a neuropsychological tool, which can be used even by non-specialists in primary care settings following a short training. The CSI-D evaluates the cognitive and functional domainsof the subjectsandincludesaninformant interview. However, it should beadapted basedonliteracy levelandsociocultural profile of population in each country. The current study examined the validity and reliability of the Persian version of the brief CSI-D in elderly patients of Iran. The current descriptive, cross sectional study was conducted on people 60 and over from 16 provinces of Iran with seven different ethnicities and various levels of education (0 - 13 to 13 years). The participants consisted of subjects with normal cognition, subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and different types of dementia. Cognitive impairment was diagnosed by a neurologist with expertise in dementia. The psychometric properties were assessed by comparing Persian version of brief CSI-D with the gold standard. Area under ROC curve, optimal cutoff point, and sensitivity and specificity were also calculated. Data were collected from 262 participants. Of all the participants, 112 were diagnosed with dementia, 64 with MCI, 32 with SCI, and 53 with normal cognition. The best cutoff point for the test- regardless of gender and level of education- was 8.5 compared with 8 - 9 in the original version of CSI-D and also the cutoff point for patient with dementia was 5.5, while it was 4 in the original version. The Persian version of CSI-D seems to be an accurate and sensitive tool to screen dementia and MCI in primary care setting, especially among low-educated and illiterate people.

Postoperative cognitive decline is a common complication observed frequently after general anesthesia in the immediate postoperative phase. We studied the effects of dexmedetomidine versus midazolam during coronary artery bypass graft (CABG) surgery on cognitive and memory function.  In this clinical trial, 42 elective on-pump CABG candidates under general anesthesia, aged between 40 and 65 years, were enrolled randomly in 2 groups. Group A received 0.05–0.1 mg/kg of midazolam and Group B received 1 µg/kg of dexmedetomidine. One day before surgery, all the participants underwent the Persian version of the Mini-Mental State Examination (MMSE) and the Persian version of the Wechsler Memory Scale (WMS) test for a comparison of cognitive impairment and memory functions. Both groups were given fentanyl and propofol for the induction of anesthesia and muscle relaxants. The MMSE and WMS tests were repeated 5 and 30 days after surgery. The mean±SD of age was 55.47±7.18 y in Group A and 55.39±6.08 y in Group B. Eighty percent of the participants were men in both groups. There were no significant differences between Group A and Group B in the MMSE and WMS before surgery (89.04±14.30 vs. 97.10±18.10, respectively;  P=0.059), but the WMS was significantly different 30 days after surgery (87.60±14.30 vs. 103.53±19.93, respectively; P=0.005). Group A showed high cognitive impairment and low WMS scores compared with Group B (P=0.005). Additionally, the MMSE results were not statistically different between the 2 groups postoperatively (24.80±3.18 vs. 23.55±4.18, respectively; P=0.394). Our results showed that dexmedetomidine might have a lower impact on cognitive function than might midazolam among patients undergoing CABG.

Objectives The current study examines the features of the physical environment affecting environmental perception and tries to explain paradigm of architecture based on the neuropsychological features. This paper investigates the relationship between the two aspects of the physical and neuropsychological environment in the patients with dementia Alzheimer’s type in order to meet the needs of the mental processes (sensation, perception, memory, and the organization of targeted behavior and adaptation to the environment for executive functions).
Methods This study was conducted by inductive content analysis method based on 9 semi-structured interviews and inductive content analysis from related literature.
Results Environmental perception was found as category based on two inductive content analyses. Moreover, 28 concepts of first level concepts (coding) and three concepts of “indifference to the elements in the physical environment”, “willingness to attend familiar places” and “stressors in unfamiliar places” as subcategories were obtained from semi-structured interviews.
Conclusion Explaining the features of the physical environment combined with neuropsychological environment can play a significant role in creating the habitat, care and treatment environment of these patients. Therefore, the sensory cue of the environment is effective in reducing behavioral disorders. Also, the perception of a more powerful environment means a greater interaction between these two dimensions of the environment.

The world’s population is growing older. Inappropriate and irrational use of drugs in the elderly is a considerable health concern due to consequences such as increased morbidity and adverse drug events. This study aimed to evaluate the rationality of prescribing and determining the extent of inappropriate prescribing in a sample of geriatric patients in Tehran.  

This cross sectional study was performed on 1512 prescriptions of patients aged ≥ 65 years from 5 pharmacies affiliated to Tehran University of Medical Sciences in 2014. Prescription of potentially inappropriate medications (PIMs) was investigated using the Beers Criteria along with WHO prescribing indices. Date were analyzed using SPSS software, and significance level was set at less than 0.05.  

Mean (SD) age of patients was 73.9(6.7) years. A total of 472 (31.2%) patients received at least 1 PIM. Benzodiazepines were the most frequent drug class and general practitioners (GPs) were the most frequent prescriber of PIMs. The highest and the lowest percentage of prescriptions containing brand-names were prescribed by subspecialists (62.5%) and GPs (42.2%), respectively. Antibiotics and injectable medications were prescribed for 26.8% and 28.5% of patients by GPs. Mean (SD) number of drugs per prescription was 3.57 (1.92). Prescriptions containing systemic antibiotics and PIMs had significantly higher mean number of drugs compared to those without these items (both P < 0.001).   

There is a need for interventions to improve the quality of prescribing for elderly patients, especially by GPs. Also, there are still some problems in rational use of drugs based on prescribing indices, especially, prescribing brand-names and injectable medications.

The growing trend of aging population and age-related diseases, such as dementia, stresses the importance of addressing caregiving. One of the notable issues in this area is the positive appraisal of caregivers of their cares, therefore, the present study aimed to explain the positive experiences of family caregivers of older adults with dementia in Iran.
This qualitative study used conventional content analysis approach. Twelve family caregivers of older adults with dementia were selected through purposeful sampling from among those attending Memory Clinic of Yadman and Alzheimer's Association of Iran in Tehran. and participated in semi-structured interviews. Data were analyzed simultaneously with data collection.
Data analysis led to the emergence of three main categories of satisfaction with care, personal growth and caregiving gains along with nine subcategories, which show the positive appraisal of caregivers of their caregiving.
According to the results of this study, although the results of our study are somewhat similar to those of the western studies, the appraisal of family caregivers of their care has unique dimensions specific to Iranian culture. These positive appraisals can be used to design specific interventions to reduce the negative outcomes of caregiving

Anomia is a common symptom that can be detrimental to the everyday communication of patients with primary progressive aphasia (PPA). Studies on the anomia treatment in PPA demonstrate that re-learning is possible, but the maintenance and generalization of improvements are limited. The treatment of word retrieval in PPA has typically centered on the retrieval of single lexical items. Little is known about the effects of word-finding treatments in discourse tasks on lexical retrieval. The purpose of this study was to introduce a combined semantic/phonological cueing treatment in the context of narrative discourse as a novel method for the treatment of word retrieval difficulty in a PPA patient and compare its effects with the effect of cueing treatment in the context of single words. One individual with PPA (FK) participated in this single-subject interventional study. FK was a 56-year-old woman with a one-year history of word finding difficulties following Frontotemporal dementia. She received 16 sessions of naming treatment over an eight-week period. The participant completed three baselines prior to treatment. The treatment used a semantic and phonological cueing hierarchy (four weeks, two times a week), followed by a cueing in a story-retelling context (four weeks, two times a week). The main outcome was the naming ability assessment score administered 10 times in order to examine the effectiveness of the therapy through statistical analysis. The participant showed a significant improvement in the word retrieval ability in all stimuli and each set separately related to the therapies phases (P < 0.001). Nevertheless, no significant differences were observed between the therapies (P = 0.26). Following the integrated therapy, FK showed a slightly significant improvement in untreated words. Generally, without considering the type of therapy during this study, in spite of the progressive nature of the disease, word retrieval ability of the patient improved via both treatment programs. Furthermore, the generalization of untreated items and maintenance of treated items also were occurred to some extents. However, there was no evidence of integrated discourse context in cueing hierarchy protocol to make it elaborated and cause a greater effect in people with PPA. As the first known study to trial this issue in the context of PPA, its findings may warrant further investigations.

Most studies show that picture-naming test is the best task to evaluate the underlined cognitive and language function in the patients with dementia. Naming performance is the most evident linguistic symptom, which starts in the initial phase of the mild cognitive impairment (MCI) and Alzheimer’s disease (AD). The current study aimed at determining the picture-naming performance level of Persian-speaking patients with MCI and AD compared with normal peers using naming subtests of Barnes language assessment (BLA). In total, 90 subjects were selected through self-report; some relevant tests including mini-mental status examination (MMSE) and functional assessment staging (FAST) scale, as well as experts comments were employed; subjects were divided into three groups of MCI, AD, and normal control (NC) (30 cases per group). Picture-naming performance of patients in the MCI and AD groups was assessed and compared with that of the NC group using the naming subtest of the BLA. In the picture-naming test of BLA, the AD group performed worse than the NC and MCI groups (P < 0.001). Moreover, a significant difference was observed between the NC and MCI groups. While the MCI group performed worse than the NC (P < 0.001), it acted better than the AD group (P < 0.001). According to the results of the current study, picture naming test was a useful cognitive-linguistic task, which can accurately differentiate the three study groups, especially MCI from normal subjects, despite its quick and simple application.

Primary Progressive Aphasia (PPA) is a neurological condition characterized by progressive dissolution of language capabilities. The Progressive Aphasia Language Scale (PALS) is an easy-to-apply bedside clinical scale capable of capturing and grading the key language features essential for the classification of PPA. The objective of the present study was to develop and validate the Persian version of the PALS (PALS-P) as a clinical language assessment test.
In this cross-sectional study, PALS was translated and adapted into Persian according to the international guidelines. A total of 30 subjects (10 subjects with PPA and 20 control subjects without dementia) were recruited to evaluate the intra-rater reliability and discriminant validity of PALS-P.
The intra-rater reliability of the PALS-P within a 14-day interval was excellent for each subtest (ICC agreement range=0.81-1.0). PALS-P results were statistically significant among groups, suggesting its discriminative validity.
This preliminary study indicates that PALS-P was successfully developed and translated. It seems to be a valid and reliable screening tool to assess language skills in Persian-speaking subjects with progressive aphasia.

Mild Cognitive Impairment (MCI), a disorder of the elderly people, is difficult to diagnose and often progresses to Alzheimer Disease (AD). Temporal region is one of the initial areas, which gets impaired in the early stage of AD. Therefore, auditory cortical evoked potential could be a valuable neuromarker for detecting MCI and AD.
In this study, the thresholds of Auditory Steady-State Response (ASSR) to 40 Hz and 80 Hz were compared between Alzheimer Disease (AD), MCI, and control groups. A total of 42 patients (12 with AD, 15 with MCI, and 15 elderly normal controls) were tested for ASSR. Hearing thresholds at 500, 1000, and 2000 Hz in both ears with modulation rates of 40 and 80 Hz were obtained.
Significant differences in normal subjects were observed in estimated ASSR thresholds with 2 modulation rates in 3 frequencies in both ears. However, the difference was significant only in 500 Hz in the MCI group, and no significant differences were observed in the AD group. In addition, significant differences were observed between the normal subjects and AD patients with regard to the estimated ASSR thresholds with 2 modulation rates and 3 frequencies in both ears. A significant difference was observed between the normal and MCI groups at 2000 Hz, too. An increase in estimated 40 Hz ASSR thresholds in patients with AD and MCI suggests neural changes in auditory cortex compared to that in normal ageing.
Auditory threshold estimation with low and high modulation rates by ASSR test could be a potentially helpful test for detecting cognitive impairment.

Caregivers’ self-assessments of the care they provide are the main vehicles that help explore their experiences and are thought to have a major role in care outcomes. The rising number of people with dementia and their need for care provided within the family makes family caregiving a major topic for study and evaluation..
The present study was conducted to assess the psychometric characteristics of the Persian version of the revised caregiving appraisal scale (RCAS) in family caregivers of older adults with dementia..
In this cross-sectional methodological study, 236 family caregivers were recruited through convenience sampling. The revised caregiving appraisal scale (RCAS) was translated using the international quality of life assessment (IQOLA) protocol, and then a panel of experts examined its face and content validities. To ensure construct validity, the translated revised caregiving appraisal scale (RCAS) was completed by 236 family caregivers, and the factor construct of the scale was assessed using five initial factors for confirmatory factor analysis. Internal consistency was confirmed using Cronbach’s alpha, and test-retest using the intraclass correlation coefficient (ICC). The confirmatory factor analysis was performed with LISREL-8.8 software for Windows®..
The mean age of the participating caregivers was 53.5 ± 13.13 years. The content and face validities of the scale were confirmed using the feedback of the family caregivers and panel of experts. The confirmatory factor analysis results reported appropriate values for all the fit indices (RMSEA = 0.046, df / χ2 = 2.428, CFI = 0.98, AGFI = 0.84, and GFI = 0.9), and the 5-factor model was confirmed with 27 items. The scale-level Cronbach’s alpha was reported as 0.894 and the scale-level ICC as 0.94. The scale met the minimum reliability standards (Cronbach’s alpha and intraclass correlation coefficient > 0.7)..
This study has provided some preliminary evidence of the reliability and validity of the Persian version of RCAS when used with family caregivers of older adults with dementia..

Postoperative cognitive dysfunction (POCD) has been an important complication of cardiac surgery over the years. Neurocognitive dysfunction can affect quality of life and lead to social, functional, emotional, and financial problems in the patient’s life. To reduce POCD, we sought to identify the association between cognitive dysfunction and perioperative factors in patients undergoing cardiac surgery. One hundred one patients aged between 45 and 75 years undergoing elective cardiac surgery were enrolled in this study. All the surgeries were performed on-pump by the same medical team. A brief Wechsler Memory Test (WMT) was administered before surgery, 3 to 5 days after the surgery, and 3 months after discharge. All related perioperative parameters were collected in order to study the effect of these parameters on the postoperative WMT scores and WMT score change. The study population consisted of 101 patients, comprising 14 (13.8%) females and 87 (86.2%) males aged between 45 and 75 years. In univariate analysis, the baseline WMT score, serum levels of lactate dehydrogenase and T3, cross-clamp time, and preexistence of chronic obstructive pulmonary disease showed significant effects on the postoperative WMT score (p value < 0.05), whereas only the baseline WMT score and chronic obstructive pulmonary disease showed strong effects on the postoperative WMT score in the multiple regression model. In addition, the multiple regression model demonstrated a significant association between the baseline WMT score, serum creatinine level, and nitrate administration and the WMT score change. Our study showed that preexisting chronic obstructive pulmonary disease and preoperative high serum creatinine levels negatively affected cognitive function after surgery. In addition, there was a strong relationship between the patients’ basic cognition and POCD. Preoperative nitrate administration led to a significant improvement in POCD. It is also concluded that the preoperative administration of specific medicines like nitrates can reduce neurological complications after cardiac surgery.