جستجوی مقالات مرتبط با کلیدواژه « Cognitive impairment » در نشریات گروه « پزشکی »

 Cognitive function is crucial during aging. This study assessed the cognitive function of European adults aged 50 and over in relation to handgrip strength and physical inactivity.

Study Design: 

This was a cross-sectional survey.

 Data were collected from 41,395 adults from 27 European countries participating in the Survey of Health, Ageing, and Retirement in Europe (SHARE) during 2019-2020. Cognitive function was assessed based on five tests, and cognitive impairment was defined using 3+tests. Handgrip strength and physical inactivity were also correlated through the analysis of covariance using a complex study design.

 The majority of participants were female (56.6%), with a mean age of 70.9 years, and 22.6% presented multimorbidity. Furthermore, 51.1% had a normal cognitive function, while 13.3% had cognitive impairment (The estimated population was 21,944,722). Moreover, cognitive impairment was more prevalent in females than in males (14.4% vs. 12.0%, P<0.001) in patients with no years of education (P<0.001) and origin from southern European countries (P<0.001). Additionally, participants with cognitive impairment had lower mean handgrip strength compared to those with cognitive impairment in 1-2 criteria or with normal cognitive function (29.3 vs. 33.4 and 35.1 kg, respectively, P<0.001). Physically inactive participants had higher odds ratio (OR) of cognitive impairment than those engaging in moderate/vigorous physical activity, both in 1-2 tests (OR:1.73, 95% confidence interval (CI): 1.32-2.26) and in 3+tests (OR: 3.36, 95% CI: 2.57-4.40).

 Cognitive impairment presented low prevalence and was associated with low levels of handgrip strength and physical inactivity. These specific factors may play a special role in early detection, diagnosis, and treatment or may slow down the progression of cognitive impairment.

One of the complications of multiple sclerosis (MS) is cognitive impairment (CI). The prevalence of CI is reported variously in previous studies. The goal of this systematic review and meta-analysis to estimate pooled prevalence of CI in patients with MS and also the prevalence of CI based on the type of applied test.

Two independent researchers systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar as well as gray literature (conference abstracts, references of the references) which were published before up January 2022.

We found 4089 articles by literature search, after deleting duplicates 3174 remained.  Ninety articles remained for meta-analysis. The pooled prevalence of CI using all types of tests was 41% (95% CI: 38-44%) (I2=91.7%, p<0.001). The pooled prevalence of CI using BRB test was 39% (95%CI: 36-42%) (I2=89%, p<0.001). The pooled prevalence of CI using BICAMS was 44% (95%CI: 37-51%, I2=95.4%, p<0.001). The pooled prevalence of CI using MACFIMS was 44% (95% CI: 36-53%)(I2=89.3%, p<0.001).

The pooled prevalence of cognitive impairment in patients with MS is estimated as 41%, so CI it should be considered by clinicians.

Chronic obstructive pulmonary disease (COPD) is a main cause of morbidity and mortality in the world. Its complications are numerous and one of their most common extra-pulmonary ones is cognitive impairment which is directly related to its mortality and morbidity. A decrease in cerebral perfusion in these patients had been seen in previous studies considering the role of VEGF on angiogenesis and its role in the pathogenesis of COPD. This study was done to evaluate the relation of cognitive impairment with serum VEGF and the number of COPD exacerbations. In the present study, 87 patients whom the pulmonologist confirmed their COPD disease based on spirometry testing were enrolled. The blood sample was received for serum VEGF level measurement and the Mini-Mental State Examination (MMSE) questionnaire was completed to assess the cognitive function. The number of exacerbations was also recorded. The blood sample was received from 87 other age and sex-matched persons without a history of pulmonary disease, CVA, or MI. Their VEGF level was also measured. The data was analyzed by SPSS version 20 software. In the COPD group, 42 (48.28%) had no cognitive impairment, 39 (44.83%) had mild, and 6(6.89%) had moderate cognitive impairment. In this group, there was a significant relation between the score of the MMSE questionnaire and the number of COPD exacerbations during the past year. However, there was no significant relation between VEGF and cognitive impairment. According to the results of the present study, there was no significant relation between cognitive impairment and VEGF level. There was a significant relation between cognitive impairment and the number of COPD exacerbations. Also, there was a significant difference between the serum level of VEGF among COPD patients and the control group.In the present study, 87patients whom their COPD disease was confirmed by the pulmonologist and spirometery testing, were selected. The blood sample was received for serum VEGF level measurement and MMSE questionnaire was completed to assess the cognitive function, number of exacerbations and coexisting systemic diseases were recorded. The blood sample was received from 87 other age and sex matched persons without history of pulmonary disease, CVA or MI and VEGF level was received. The data was analyzed by SPSS20.In COPD group, 48.27% had no cognitive impairment,44.82% had mild and 6.89% had moderate cognitive impairment. According the results of the present study, there was no significant relation between cognitive impairment and VEGF level. There was a significant relation between cognitive impairment and number of COPD exacerbations and there was a significant difference between the serum level of VEGF among COPD patients and control .

Coronavirus-2019 (COVID-19) spreads rapidly worldwide and causes severe acute respiratory syndrome. The current study aims to evaluate the relationship between the whole-brain functional connections in a resting state and cognitive impairments in patients with COVID-19 compared to the healthy control group.

Resting-state functional magnetic resonance imaging (rs-fMRI) and Montreal cognitive assessment (MoCA) data were obtained from 29 patients of the acute stage of COVID-19 on the third day of admission and 20 healthy controls. Cross-correlation of the mean resting-state signals was determined in the voxels of 23 independent components (IC) of brain neural circuits. To assess cognitive function and neuropsychological status, MoCA was performed on all participants. The relationship between rs-fMRI information, neuropsychological status, and paraclinical data was analyzed.

The COVID-19 group got a lower mean MoCA score and showed a significant reduction in the functional connectivity of the IC14 (P<0.001) and IC38 (P<0.001) regions compared to the controls. The increase in functional connectivity was observed in the COVID-19 group compared to the controls at baseline in the default mode network (DMN) IC00 (P<0.001) and dorsal attention network (DAN) IC08 (P<0.001) regions. Furthermore, the alternation of functional connectivity in the mentioned ICs was significantly correlated with the mean MoCA scores and inflammatory parameters, i.e. erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Functional connectivity abnormalities in four brain neural circuits are associated with cognitive impairment and increased inflammatory markers in patients with COVID-19.

Methamphetamine (MA), is a widely abused synthetic psychostimulant that leads to irreversible brain damage manifested as cognitive impairments in humans and animals. The novel object recognition (NOR) task is a commonly used behavioral assay for the investigation of non-spatial memory in rodents. This test is based on the natural tendency of rodents to spend more time exploring a novel object than a familiar one. NOR test has been used in many studies investigating cognitive deficits caused by MA in rodents. The objective of the present study was to review neurobiological mechanisms that might be responsible for MA-induced NOR alterations. 

A PubMed search showed 83 publications using novel object recognition and methamphetamine as keywords in the past 10 years. 

The present study revealed different MA regimens cause recognition memory impairment in rodents. In addition, it was found that the main neurobiological mechanism involved in MA-induced recognition deficits is the dysfunction of monoaminergic systems. 

NOR is a useful test to assess the cognitive functions following MA administration and evaluate the efficacy of new therapeutic agents in MA-addicted individuals.

The increase in age-related cognitive impairment (CIs) and diabetes mellitus is a global health concern. Exercise training has been reported to activate the Nrf2/Keap1/ARE signaling and enhance the antioxidant defense pathways in some animal models. This study aimed to investigate the effects of ursolic acid (UA) associated with resistance or endurance training on antioxidant markers, and the Nrf2/Keap1/ARE pathway in the brain of older diabetic rats. 23-month-aged diabetes induced male Wistar rats were randomly assigned to seven groups (n=8). UA supplementation (250 mg/kg, daily) was administered along with resistance (60% maximum capacity of voluntary carrying [MVCC], 14-20 climbs) or endurance training (60-75% velocity at maximal oxygen uptake [vVO2max]), five days/week for eight weeks. Cognitive-motor functioning was assessed through open-field and passive avoidance response tests. Nrf2, Keap1, and antioxidant markers including SOD, CAT, GPx, and GSH were measured in the hippocampus tissue. The results showed positive effect of resistance training (P≤0.001) on Nrf2. There was endurance training with supplementation main effect (P=0.018) on Keap1 concentration. SOD revealed a significant endurance/resistance training by supplementation interaction effect (P≤0.05); however, there was no main training or UA supplementation effects on CAT, GPx, and GSH, despite improving spatial memory changes in exercise or UA groups.  It appears that UA treatment with resistance or endurance exercise has some beneficial effects on Nrf2 and some antioxidant markers. However, more research is needed to elucidate UA’s interaction effects and exercise interventions in diabetic situations.

Patients with chronic kidney disease (CKD) have increasingly been diagnosed with cognitive impairment. Glycogen synthase kinase 3β (GSK3β) is directly causing both phosphorylated tau (pTau) and amyloid β (Aβ) accumulation in Alzheimer’s disease (AD). GSK3β expression is more abundant in human platelets than in other blood cells. Recombinant human erythropoietin (rHuEPO) is a common medicine for treating anemia in patients with CKD, as well as a neuroprotective agent.

The goal of this research is to find out how platelet GSK3β regulates plasma Aβ, total Tau and tau phosphorylated at threonine 181 (p-tau181) levels in CKD patients with cognitive dysfunction and also the efficacy of rHuEPO treatment. Patients and

The study included 60 participants, which consist of 30 CKD without cognitive dysfunction and 30 CKD with cognitive dysfunction based on the neuropsychological examination. The expression of GSK3β in platelets was evaluated using a western blot and plasma Aβ, total Tau, pTau 181 levels were quantified by ELISA. The data were compared statistically (P < 0.05) to AD, normocytic normochromic anemic and healthy patients.

In CKD with cognitive dysfunction subjects, platelet GSK3β expression and plasma Aβ, total Tau and pTau181 levels were significantly (P < 0.05) altered like AD when compared to normocytic normochromic anemic, healthy and CKD without cognitive dysfunction subjects. In post rHuEPO (100 IU/kg, weekly twice, six months) treatment, the altered protein abnormalities were retrieved significantly (P < 0.05) compared to pre-treatment.

This study established that platelet GSK3β expression and plasma Aβ, total Tau, pTau181 are the candidate biomarkers for cognitive dysfunction in CKD patients. The clinical utility of rHuEPO as a GSK3β inhibitor and therapeutic agent for cognitive dysfunction in CKD has been determined.

Depression and cognitive impairment are two psychosocial health problems significantly affecting the quality of life of older adults across the globe. This study aimed to estimate the prevalence of psychosocial morbidities among older adults in a rural community of coastal Karnataka, India, and to determine the socio-demographic correlates of these morbidities. This cross-sectional study was conducted in rural and semi-urban Udupi taluka, in southern India. A total of 1,832 men and women aged ≥60 years were surveyed from 2015 to 2017 using a simple random method. Data was collected from the participants through an interviewer-administered pre-designed semi-structured questionnaire, Geriatric depression scale-Short version, and Everyday Abilities Scale India, and data were analyzed using SPSS version 26.0. Prevalence of depression and cognitive impairment among the study participants were reported, and significant sociodemographic predictors of these morbidities were determined using multivariate analysis. Prevalence of depression and cognitive impairment were 38.7% and 49.1%, respectively, among older adults. Low literacy, low socioeconomic status, and unemployment were significant predictors of depression, while only low literacy was found to be the predictor of cognitive impairment. Further, being employed in old age showed a protective effect on their cognitive health. Psychosocial problems were highly prevalent among community-dwelling older adults. Improving their general health conditions, getting them involved in social activities tailored to their abilities and preferences, and ensuring economic independence through social security measures would pave the way in enhancing the mental health of older adults in southern India.

In the 1880s, German physician Georg Greiner coined the concept of “brain fog” to describe the cognitive deficits associated with delirium. The term “brain fog” has been used intermittently since then to describe sluggish cognition. It gained popularity again in the 1990s as a way to describe chronic fatigue syndrome and some autoimmune diseases. However, there are no diagnostic criteria for brain fog and it is not a medical condition.1 The term “brain fog” describes cognitive difficulties that are increasingly used colloquially. Long-term COVID-19 is characterized by persistent symptoms following a COVID-19 diagnosis that cannot be explained by any other illness. Persistent symptoms following COVID-19 are often described as “brain fog.” Brain fog syndrome, which is associated with excessive academic strain, was revived in the 1960s and was included in the DSM-IV.2 As a result of post-COVID-19 infection, residual cognitive impairment (“brain fog”) often interferes with work and daily activities.3 Recent investigations have shown that fungal co-infections significantly affect the morbidity and mortality of patients with COVID-19.

Context: 

The number of people with dementia is increasing dramatically. With the outbreak of the COVID-19 pandemic, digital screening tests can play a significant role in the remote and timely detection of people with dementia. This study aimed to review digital cognitive tests for dementia screening.

We searchedWeb of Science, ProQuest, PubMed, Scopus, and Cochrane using related terms such as “dementia,” “mobile,” “digital,” “computer,” and “cognitive assessment,” leading to the emergence of 1,348 articles. Titles, abstracts, and full texts were screened to select the relevant articles based on inclusion/exclusion criteria. Study characteristics and digital test features such as diagnostic performance and deploying platforms were extracted from selected articles. The risk of bias and reporting quality were evaluated in the included studies.

Out of 1,348 identified articles, 32 were eligible for inclusion. We categorized digital cognitive tests into 3 groups based on deploying platforms: 1) Mobile-based screening tests (59.5%), 2) desktop-based screening tests (28%), and 3) web-based screening tests (12.5%).

Digital cognitive tests, especially mobile-based screening tests, facilitate the timely diagnosis of dementia. The development of AI-based screening tests and the use of technologies such as virtual reality and chatbots will set a bright future in the early detection of dementia.

Myotonic Dystrophy type 1 (DM1) is a progressive life-threatening disorder that affects several systems in the human body. Besides physical involvements, previous studies reported various psychiatric and cognitive presentations in these patients. We presented a 65-year-old patient with adult-onset DM who suffered from multi- system involvement. She has also experienced a series of psychiatric symptoms including depressed mood, insomnia, fatigue, reference delusion, visual and auditory hallucinations besides impaired cognitive functions. With the diagnosis of major depressive disorder with psychotic features, she was treated with Sertraline and Haloperidol. The cognitive impairment was continued after improvement in mood, and donepezil 5 mg was prescribed. Whereas patients with DM1 and with psychiatric manifestations have significantly lower function than those without psychiatric symptoms, clinicians should be aware of the mental status examination and eventual psychiatric disorders in these patients. Our case presentation suggests a multidisciplinary approach to these patients to provide comprehensive health care.

Sleep deprivation is a common health problem in modern society and is negatively associated with deleterious effects on cognitive functions such as learning and memory ability. This study was undertaken to provide a detailed account of the effect of chronic ozone intraperitoneal injection on the deleterious effects of sleep deprivation on brain function in rats.  Sleep deprivation was induced using the modified multiple platform model. The rats received REM sleep deprivation with an intraperitoneal injection of ozone or midazolam for 28 days. The effects of ozone on REM sleep deprivation-induced hippocampus-dependent learning and memory deficits were studied by the following approaches: Morris water maze (MWM) tests were used to evaluate spatial learning and memory of rats. Morphological changes in the brain were evaluated using hematoxylin and eosin (HE) staining. RNA-sequence was performed to seek a common mechanism. The expression of the targeted gene was examined by qPCR and Western blotting. Ozone intraperitoneal injection reversed spatial learning and memory deficits associated with REM sleep deprivation, ameliorating pathological brain damage and down-regulating the hippocampal expression of Sema3A in rats after REM sleep deprivation.  Ozone intraperitoneal injection alleviated sleep deprivation-induced spatial learning and memory deficits by protecting hippocampal neurons via down-regulation of the expression of Sema3A in the hippocampus.

The present study aimed to address the effect of Rituximab on the cognitive impairment in patients with secondary progressive MS (SPMS).

The present interventional study used a convenience sampling method to select the study participants from SPMS patients. All these patients had progressive disability over the last two years before being admitted in the study. Prior to the administration of Rituximab, the minimal assessment of cognitive function in the multiple sclerosis (MACFIMS) test was performed for each patient who was a candidate to be included in this study. This test was repeated by passing 6 and 12 months from the initial treatment with Rituximab. Since the data needed for this study were obtained at different time intervals, so a linear mixed model was used for their analysis. Analysis of variance (ANOVA) was also used to investigate whether time and sex generally affect the cognitive impairments in SPMS patients. A p-value <0.05 was considered as statistically significant in this study.

Of the total 35 patients, 34% and 66% were men and women with a mean age of 41.33 and 41.39 years old, respectively. Rituximab showed a significant positive effect on a number of subgroups of MACFIMS test, including Controlled Oral Word Association Test (COWAT) (P-value: 0.038) and Brief Visuospatial Memory Test (BVMT-total) (P- value: 0.019).

The present study revealed that Rituximab has a positive effect on the cognitive impairment resulted from MS in secondary progressive patients.

The elders need proper medical and psychiatric care and attention, so choosing a suitable therapeutic approach for their psychological care, especially in those with cognitive impairment, will be effective in improving psychological symptoms and their health. The present study aimed to investigate the effectiveness of cognitive rehabilitation on agitation, apathy and cognitive function.

This quasi-experimental study carried out among male elders with mild cognitive impairment (MCI) in Kahrizak Charity nursing home in Alborz province in 2020. A sample of 36 male elders with MCI was purposefully selected and randomly assigned to experimental (n = 18) and control (n = 18) groups. Data were collected through Cohen-Mansfield Agitation Inventory; Apathy Evaluation Scale and Montreal Cognitive Assessment-Basic. The intervention group received 8 sessions of 90 minutes, cognitive rehabilitation based on kelly and O'Sullivan's cognitive rehabilitation strategies and techniques.

After controlling the mean scores of the pretest, a significant difference was observed in agitation (96.6 vs 101.9) apathy (30.02 vs 34.10) and cognitive function (19.60 vs 16.80) between experimental and control groups. This means that cognitive rehabilitation reduced agitation and apathy with effect sizes of 0.42 and 0.54 respectively and increased cognitive function with an effect size of 0.65.

Considering the effectiveness of cognitive rehabilitation in reducing agitation, apathy and increasing cognitive function of the participants, cognitive rehabilitation is suggested to improve individual functioning and interpersonal relationships in the elderly with MCI.