Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors / Avaliação cognitiva em crianças pré-termo usando Bayley-III: desenvolvimento no primeiro ano de vida e fatores associados

ABSTRACT Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.

RESUMO Objetivo: Avaliar o desenvolvimento cognitivo de crianças pré-termo aos seis e 12 meses de idade corrigida e as associações com fatores perinatais e socioeconômicos. Métodos: O desenvolvimento cognitivo de 40 crianças (20 pré-termo e 20 a termo) foi avaliado aos seis e 12 meses de idade, utilizando a escala Bayley-III. Correlações entre resultados cognitivos e fatores associados foram avaliadas pelo teste de correlação de Spearman. A análise de regressão linear múltipla stepwise com covariância foi aplicada para identificar mudanças na pontuação cognitiva entre seis e 12 meses. Resultados: O escore cognitivo no grupo pré-termo foi significativamente menor que no grupo a termo aos seis e 12 meses. O peso ao nascer foi diretamente associado com o desempenho cognitivo aos seis meses e perímetro cefálico ao nascimento aos 12 meses, nas crianças a termo. A ocorrência de enterocolite necrosante foi inversamente associada ao desempenho cognitivo em pré-termos, aos 12 meses. Verificou-se aumento na pontuação cognitiva entre seis e 12 meses nos dois grupos, porém mais pronunciado no pré-termo. Conclusões: O estudo sugere que crianças pré-termo apresentam alguma capacidade de recuperação cognitiva no primeiro ano, apesar das restrições impostas pelo nascimento prematuro, e enfatizam a importância de acompanhamento dessa população desde os primeiros meses de vida.

A privação do sono e seus impactos no desenvolvimento de transtornos neurodegenerativos / Sleep deprivation and its impacts on the development of neurodegenerative disorders / La privación del sueño y su impacto en el desarrollo de trastornos neurodegenerativos

Introdução: A redução do tempo de sono, abaixo das necessidades básicas individuais, denominada privação do sono (PS) é alvo de pesquisas que buscam entender seus efeitos no organismo humano. Estudos em indivíduos que experienciam a PS regularmente demonstraram consequências negativas da prática na saúde humana. Objetivo: A fim de aprofundar o entendimento sobre o tema, esta revisão integrativa de literatura tem o objetivo de elucidar os impactos da PS na cognição, no humor e no desenvolvimento de transtornos neurodegenerativos. Métodos: Por meio da leitura de artigos, selecionados pelo método PRISMA, e da síntese de seus resultados. Resultados: Após análise, foram selecionados 18 artigos, que discutiam sobre o desenvolvimento de doenças neurodegenerativas. Como resultado, observou-se predominância, nos artigos, de impactos negativos da PS sobre o tema estudado, com pequena minoria demonstrando resultados inconclusivos ou sem impacto/impacto significativo, e sem relatos de impactos positivos. Nota-se prejuízos da PS no desenvolvimento de doenças neurodegenerativas, com alta relação à Doença de Alzheimer e relatos sobre Doença de Parkinson, Doença de Huntington e Esclerose Múltipla. Conclusão: Portanto, constata-se como a PS pode exercer impactos negativos no ser humano, notadamente para o desenvolvimento de transtornos neurodegenerativos.

Introduction: The reduction of sleep time, below individual basic needs, called sleep deprivation (SD), is the subject of research that seeks to understand its effects on the human body. Studies in individuals who experience SD regularly have shown negative consequences of this practice on human health. Objective: In order to deepen the understanding of the subject, this integrative literature review aims to elucidate the impacts of SD on the development of neurodegenerative disorders. Methods: Through the reading of articles, selected by the PRISMA method, and the synthesis of their results. After analysis, 18 articles were selected, in which was discussed the development of neurodegenerative. Results: As a result, there was a predominance, in the articles, of negative impacts of SD on the studied aspect, with a small minority demonstrating inconclusive results or results without impact or significant impact, and without any reports of positive impacts. It is noticeable that SD results in damages in the development of neurodegenerative diseases, with great association with Alzheimer's Disease and one report associating SD and Parkinson's Disease, Huntington's Disease and Multiple Sclerosis. Conclusion: Therefore, it is clear how SD can have negative impacts on humans, notably for the development of neurodegenerative disorders.

Introducción: La reducción del tiempo de sueño, abajo de las necesidades básicas individuales, denominada privación de sueño (PS), es objeto de investigación, que busca comprender sus efectos en el organismo humano. Los estudios en individuos que experimentan PS regularmente han mostrado consecuencias negativas de esta práctica en la salud humana. Objetivo: Con el fin de profundizar en la comprensión del tema, esta revisión integrativa de la literatura tiene como objetivo dilucidar los impactos de PS en el desarrollo de trastornos neurodegenerativos. Metodología: Através de la lectura de artículos, seleccionados por el método PRISMA, y la síntesis de sus resultados. Después del análisis, se seleccionaron 18 artículos, que discutieron el desarrollo de trastornos neurodegenerativos. Resultados: Como resultado, fue observado un predominio, en los artículos, de impactos negativos de la DS sobre lo aspecto estudiado, con una pequeña minoría demostrando resultados no concluyentes o resultados sin impacto o impacto significativo, y sin informes de impactos positivos. Es notorio que la PS resulta en daños en el desarrollo de enfermedades neurodegenerativas, con gran asociación con la Enfermedad de Alzheimer y un reporte asociando SD y Enfermedad de Parkinson, Enfermedad de Huntington y Esclerosis Múltiple. Conclusión: Por lo tanto, está claro cómo el PS puede tener impactos negativos en los seres humanos, en particular para trastornos neurodegenerativos.

Expression of CircRNA_0005853 in elderly patients with acute cerebral infarction and its correlation with cognitive dysfunction / 中国医师杂志

Objective:To explore the correlation between the expression level of the serum CircRNA_ 0005853 and cognitive impairment in elderly patients with acute cerebral infarction (ACI).Methods:A total of 120 elderly patients with ACI admitted to Haikou Third People′s Hospital from January 2019 to March 2022 were retrospectively selected. According to the Montreal Cognitive Assessment (MoCA) score of the patients 4 weeks after treatment, they were divided into a cognitive impairment free group (MoCA score≥26, 55 cases) and a cognitive impairment group (MoCA score<26, 65 cases). The cognitive impairment group was redivided into mild group (MoCA score 21-25, 16 cases), moderate group (MoCA score 15-20, 38 cases), and severe group (MoCA score<15, 11 cases) based on the severity of cognitive impairment. The serum CircRNA_0005853 expression level of each group was compared. multivariate logistic regression analysis was applied to identify the risk factors for cognitive impairment after ACI. A receiver operating characteristic (ROC) curve was drown to analyze the value of CircRNA_0005835 expression level in predicting cognitive impairment. Using Pearson correlation analysis, the correlation between the expression level serum CircRNA_0005835 and MoCA score in patients with cognitive impairment was analyzed.Results:There were statistically significant differences in age, infarct size, and triglycerides between the cognitive impairment group and the non cognitive impairment group (all P<0.05). The MoCA score of the cognitive impairment group was lower than that of the non cognitive impairment group [(19.62±2.73)points vs (28.10±1.05)points, P<0.001]. The expression level of Serum CircRNA_0005835 in the cognitive impairment group was higher than that of the non cognitive impairment group (2.48±1.02 vs 1.25±0.46, P<0.001), and in the severe group, the expression level of the serum CircRNA_0005835 (2.90±1.26) was higher than that of the moderate group (1.87±0.84) and the mild group (0.92±0.35) ( P<0.001). Multivariate logistic regression analysis shew that age ( OR=1.662, 95% CI: 1.140-2.873), infarct size>3.0 cm 2 ( OR=1.853, 95% CI: 1.317-4.112), and CircRNA_0005835 ( OR=2.217, 95% CI: 1.635-5.540) were risk factors for cognitive impairment after ACI. The area under the curve (AUC) of CircRNA_0005835 expression level predicting cognitive impairment was 0.837(95% CI: 0.779-0.894), with a sensitivity of 80.2% and a specificity of 83.7%. The AUC of CircRNA_0005835 expression level predicting cognitive impairment was 0.837(95% CI: 0.779-0.894), with a sensitivity of 80.2% and a specificity of 83.7%. The correlation analysis shew that the expression level of serum CircRNA_0005835 in elderly ACI patients was negatively correlated with MoCA score ( r=-0.773, P<0.001). Conclusions:The increased expression level of serum CircRNA_0005853 is related to the occurrence and development of cognitive dysfunction after elderly ACI, and has certain value in predicting cognitive dysfunction.

Research progress of cerebral microbleed and cognitive impairment / 中国医师杂志

Cerebral microbleed (CMB) is a type of cerebral small vessel disease (CSVD). Recently studies have found that there is a certain relationship between CMB and cognitive impairment. This article mainly reviews the etiology of CMB, the relationship between CMB and cognitive impairment, CMB and cognitive disorders and the possible mechanism of CMB-related cognitive impairment, in order to improve the understanding of cognitive impairment caused by CMB.

The effect of fascia iliaca compartment block continuous analgesia in the early stage on early postoperative cognitive in patients with hip fractures / 中国医师进修杂志

Objective:To investigate the effect of fascial iliaca compartment block (FICB) continuous analgesia in the early stage after admission on early postoperative cognitive and motor function in elderly patients with hip fractures.Methods:A total of 80 elderly patients with hip fractures admitted toThe First Affiliated Hospital of Tsinghua University from June 2018 to June 2020 were selected and randomly divided into the control group and the observation group, with 40 cases in each group. The control group adopted the routine postoperative analgesia regimen, while the observation group adopted FICB analgesia immediately after admission to the hospital until before the operation. Postoperative analgesia pattern was consistent with that of the control group, and both groups were given postoperative analgesia for 48 h. The scores of visual analogue scale (VAS), mini mental state assessment scale (MMSE), Harris hip score (Harris) and surgical indexes, stress indexes and incidence of adverse reactions were compared between the two groups.Results:The levels of postoperative blood glucose, cortisol, angiotensin Ⅱin the observation group were lower than those in the control group: (5.21 ± 1.03) mmol/L vs. (7.03 ± 1.06) mmol/L, (643.08 ± 77.28) nmol/L vs. (747.96 ± 82.80) nmol/L, (41.03 ± 5.22) ng/L vs. (57.15 ± 8.16) ng/L, there were statistically differences ( P<0.05). The dosage of sufentanil in the observation group was lower than that in the control group: (27.48 ± 3.25) mg vs. (58.54 ± 4.86) mg, there was statistically difference ( P<0.05). The scores of VAS score at 12 h before surgery, 12 h and 48 h after surgery in the observation group were lower than those in the control group, and the scores of MMSE score were higher than those in the control group, there were statistically differences ( P<0.05). After the surgery, the Harris scores in the observation group was higher than that in the control group: (76.09 ± 6.11) scores vs. (65.62 ± 6.13) scores, there was statistically difference ( P<0.05). The incidence rate of postoperative cognitive dysfunction (POCD) in the observation group was lower than that in the control group: 2.5%(1/40) vs. 15.0%(6/40), there was statistically difference ( χ2 = 3.91, P<0.05). Conclusions:FICB continuou sanalgesic in the early stage after admission of elderly patients with hip fracture is satisfactory, which can effectively relieve postoperative pain, while the stress response is relatively mild, the recovery of postoperative cognitive function and hip function is good.

Research progress on cognitive dysfunction and brain gray matter areas changes in patients with obstructive sleep apnea hypopnea syndrome / 中华神经科杂志

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a sleep breathing disorder caused by obstruction of the upper airway during sleep from various causes. At present, the diagnosis and treatment of OSAHS are insufficient. OSAHS causes cognitive decline due to excessive oxidative stress and inflammatory response caused by sleep breathing disorder, and its alteration of the brain gray matter area may be related to cognitive dysfunction. This review investigates the correlation between cognitive dysfunction and brain gray matter areas changes in OSAHS, and elucidates the underlying mechanisms, which provide a theoretical basis for early clinical diagnosis and treatment.

Correlation of cognitive function with intracranial lesions and the degree of depression and anxiety in patients with neuromyelitis optica spectrum disorders / 中华内科杂志

Objective:To investigate the correlation of cognitive dysfunction with intracranial lesions and symptoms of depression and anxiety in patients with neuromyelitis optica spectrum disorders (NMOSD).Methods:Thirty-one NMOSD patients (7/24 males/females) were enrolled in the Department of Neurology of the Sixth Medical Center of the PLA General Hospital from August 2019 to August 2022. The average age was 42±13 years, and the average education level was 12 (9, 12) years. There were 30 healthy controls, 11/19 males/females, with an average age of 47±9 years and an average education of 12 (9, 15) years. The general clinical data and imaging data were collected, and the subjects were assessed on their cognition, anxiety and depression using the assessment scale approved at home and abroad. A cross-sectional study was conducted on them. The t-test or Wilcoxon test was used for inter-group comparison, and Pearson test or Spearman test was used to explore the correlation between the cognition of NMOSD patients and their intracranial lesions, depression and anxiety. Results:Compared with the healthy control group, NMOSD patients had significantly lower scores on MoCA ( Z=-3.10, P=0.002), CRAVLT-N7 ( Z=-5.12, P<0.001), CRAVLT-N8 ( t=-4.40, P<0.001), ROCF-R ( t=-3.10, P<0.01), ROCF-C ( Z=-2.72, P<0.01), PASAT-3 ( Z=-2.71, P<0.01), PASAT-2 ( Z=-3.14, P<0.01), and CWT-A ( Z=-3.10, P<0.01)scales. Frontal lobe lesions were negatively correlated with PASAT-2 ( r=-0.448, P=0.012) scores, temporal lobe lesions were negatively correlated with CRAVLT-N9 ( r=-0.564, P=0.001), and parietal lobe lesions were negatively correlated with MoCA ( r=-0.374, P=0.038), PASAT-3 ( r=-0.426, P=0.017), and PASAT-2 ( r=-0.459, P=0.009) scores; The scores of MoCA ( r=-0.392, P=0.029), CRAVLT-N6 ( r=-0.396, P=0.028), CRAVLT-N7 ( r=-0.415, P=0.020), CRAVLT-N8 ( r=-0.406, P=0.023), PASAT-3 ( r=-0.537, P=0.002) and PASAT-2 ( r=-0.495, P=0.005) scales were negatively correlated with the scores of HAMD assessment, and the scores of PASAT-3 ( r=-0.499, P=0.004) and PASAT-2 ( r=-0.452, P=0.011) were negatively correlated with the scores of HAMA. Conclusions:The cognitive function of patients with NMOSD is significantly reduced, involving multiple cognitive domains. The cognitive function is affected by the distribution of intracranial lesions and the degree of depression and anxiety.

Advances in the effect of body temperature on perioperative neurocognitive disorders in elderly patients / 中华老年医学杂志

Perioperative neurocognitive disorders(PND)is a common complication after surgery or anesthesia, especially in elderly patients.The effects and mechanism of body temperature on PND are still controversial.In this paper, the relationship between body temperature and PND and its possible mechanism of action were discussed based on some research results of perioperative body temperature management in elderly patients, aiming at suggesting the significance of body temperature management in preventing PND.

Asymptomatic cerebral artery stenosis and cognitive impairment / 国际脑血管病杂志

Asymptomatic cerebral artery stenosis (aCAS) is closely associated with cognitive impairment, which can lead to multiple cognitive domain impairments, thereby affecting the behavior and daily life of patients. This article reviews the main involved cognitive domains, injury mechanisms, and treatment in different types of aCAS, with the aim of increasing attention to aCAS, early clinical intervention, and delaying cognitive deterioration.

Diffusion magnetic resonance imaging of patients with cerebral small vessel disease related cognitive impairment / 国际脑血管病杂志

Cerebral small vessel disease (CSVD) is a group of pathological, imaging and clinical syndromes involving small cerebral vessels with different causes. The incidence rate of CSVD increases with age and is the most important cause of vascular cognitive impairment. Different diffusion imaging techniques can quantify white matter microstructure damage by revealing the diffusion movement of water molecules in specific brain tissues, explore the basis and biophysical mechanisms of tissue change, and have important value for the mechanism research, early diagnosis, progression risk, and therapeutic evaluation of cognitive impairment related to CSVD. This article reviews the research progress of diffusion magnetic resonance imaging in CSVD related cognitive impairment.

Correlation between paroxysmal slow-wave events and cognitive impairment in patients with cerebral small vessel disease / 国际脑血管病杂志

Objective:To investigate the correlation between paroxysmal slow-wave events (PSWEs) and cerebral small vessel disease (CSVD) and CSVD-related cognitive impairment.Methods:Patients with CSVD visited Weihai Municipal Hospital from March 2021 to April 2022 were included, and sex- and age-matched healthy controls were recruited for cross-sectional analysis. The patients with CSVD were further divided into cognitive impairment group and non-cognitive impairment group. The self-developed Python script was used to detect the PSWE parameters in electroencephalogram records. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate cognitive function. Multivariate logistic regression analysis was used to determine whether PWSE parameters were the independent related factors of CSVD and CSVD-related cognitive impairment. Multiple linear regression analysis was used to determine the correlation between the PSWE parameters and overall cognitive function (MoCA total score) in patients with CSVD. Results:A total of 76 patients with CSVD (including 41 patients with cognitive impairment and 35 patients without cognitive impairment) and 45 healthy controls were included. Compared with the healthy control group, PWSEs in the F3 (left frontal area) and O1 (left occipital area) regions of the CSVD group occurred more frequently and lasted longer (all P<0.05). Multivariate logistic regression analysis showed that the frequency (odds ratio [ OR] 1.080, 95% confidence interval [ CI] 1.023-1.140; P=0.005) and duration ( OR 1.006, 95% CI 1.001-1.011; P=0.023) of PWSEs in the left frontal area, as well as the frequency ( OR 1.052, 95% CI 1.010-1.095; P=0.014) and duration ( OR 1.003, 95% CI 1.000-1.006; P=0.028) of PWSEs in the left occipital region were the independent related factors for CSVD. The frequency ( OR 1.106, 95% CI 1.033-1.183; P=0.004) and duration ( OR1.010, 95% CI 1.003-1.017; P=0.004) of PWSEs in the left frontal area were the independent risk factors for cognitive impairment in patients with CSVD. Multiple linear regression analysis showed that the frequency ( β= –0.242, P=0.045) and duration ( β= –0.235, P=0.046) of PWSEs in the left frontal region were negatively correlated with the overall cognitive function score in patients with CSVD. Conclusions:The frequency and duration of PSWEs in some brain regions of patients with CSVD increase, and there is an independent correlation between PSWEs and cognitive impairment, suggesting that the damage of blood-brain barrier may participate in the pathogenesis of cognitive impairment in patients with CSVD.

SNORE (Sleep Deprivation Among Night Shift Health Staff on Rotation Evaluation) Study Protocol

Background: SNORE (Sleep deprivation among Night shift health staff On Rotation-Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation. Materials and Methods: A comparative cross-sectional study is devised including health-care profes-sionals working night shifts on rotation at a tertiary level health-care facility, using a semi-structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to ap-proach 309 probable study participants based on stratified random sampling, after exclusion of health-care professionals with other factors which may interfere with sleep deprivation testing. Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive im-pairment, especially among health care professionals working night shifts.

Cognitive Alterations in Elderly Patients with Heart Failure'

Abstract Background: Among the various pathologies that affect the elderly, Heart Failure (HF) stands out. Recently, an attempt has been made to verify the existence of cognitive impairment associated with HF. Objectives: To compare the cognitive performance of elderly people with heart failure with that of age-matched individuals without this pathology. Check the existence of marked impairment in some cognitive functions in the clinical group. Methods: The sample consisted of 78 elderly people, whose inclusion criterion was the presence of HF and no HF (control group); age over 60 years, both sexes, and any level of education. The control group consisted of 37 individuals (with a median age of 68 years - Interquartile range of 12) and the HF group, with 41 individuals (with a median age of 67 years - Interquartile range of 11). The subjects were matched in terms of education level, with a predominance of elderly people with 0 to 4 years of education (65.9% in the Clinical Group and 59.5% in the Control Group). Eleven neuropsychological tests covering cognitive functions were used: attention, language, memory, mood, and executive function. Statistical analysis was performed using SPSS software, version 23, with a significance level of 5%. The Chi-square test and the Mann-Whitney test were applied. Results: The results showed significant differences between the groups, mainly in executive functions, which include the ability to plan, switch, and recall previously stored information. Conclusion: Our study showed differences between the cognitive performance of elderly people with HF and elderly people without HF. The main alteration was found in the so-called executive functions, attention, and memory.

Research progress in the assessment of nutritional status and dietary factors in the elderly and their correlation with cognitive impairment / 中国医师杂志

Dietary factors and nutritional status are closely related to the occurrence of cognitive impairment in the elderly. Excessive intake of nutrients such as lipids and carbohydrates in the diet is related to the occurrence of cognitive impairment. However, certain trace elements in the diet have a preventive effect on cognitive impairment. Based on the correlation analysis of dietary factors, nutritional status and cognitive impairment in the elderly, this paper expounds the relationship between cognitive impairment and its specific mechanism of action, in order to change the lifestyle of the elderly with cognitive impairment to improve their quality of life, and to provide a certain theoretical basis for the construction of dietary habits in line with national life.

Pay attention to the relationship between cognitive reserve and vascular cognitive impairment / 中华神经科杂志

Vascular cognitive impairment (VCI), one of the most common causes of cognitive impairment, severely influences the lifetime and daily life abilities in the elder population. Cognitive reserve (CR) can compensate the damage caused by aging and brain pathology. The risk factors of CR include intelligence quality, education, occupation achievement, leisure activities, bilingualism, traumatic brain injury and vascular risk factors. Single proxy indicator and questionnaire composed of several different proxy indicators have been developed to measure CR. Cognitive Reserve Index Questionnaire is the most commonly used scale of CR. CR is not only associated with the severity of post-stroke cognitive impairment, but also the rapid cognitive recovery early after stroke. CR also plays a great role in the cognitive impairment related to small cerebral vessel diseases. Many problems on CR exist among the clinical application and clinical research, such as the underlying biological mechanisms, excessively emphasizing socioeconomic indicators in the CR questionnaire and unclear weighting score of single indicators in the CR questionnaire. More attention should be paid to mechanism research and relationship between CR and VCI.

Role of PKA-CREB signaling pathway in sevoflurane-induced reduction of cognitive impairment caused by cardiopulmonary bypass in rats / 中华麻醉学杂志

Objective:To evaluate the role of protein kinase A (PKA)-cyclic adenosine monophosphate response element binding protein (CREB) signaling pathway in sevoflurane-induced reduction of cardiopulmonary bypass (CPB)-induced cognitive impairment in rats.Methods:Forty healthy male Sprague-Dawley rats, aged 4 months, weighing 300-350 g, were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), group CPB, CPB+ sevoflurane group (group CS) and CPB+ sevoflurane+ PKA inhibitor H89 group (group CSH). After H89 5 μl was injected into the lateral ventricle in group CSH, the rats in group CS and group CSH were exposed to 2.4% sevoflurane for 1 h, and then the CPB model of beating heart without blood priming for 60 min was developed in CPB, CS and CSH groups.The autonomic movement ability was evaluated using the open field test at 2nd day after CPB.Morris water maze test was used to assess the cognitive function at 3rd day after CPB.The rats were sacrificed after the Morris water maze test, the brain was removed and the hippocampal tissues were isolated for determination of the apoptosis rate of hippocampal neurons (by flow cytometry) and expression of PKA, phosphorylated CREB (p-CREB) and brain-derived neurotrophic factor (BDNF) (by Western blot). Results:There was no significant difference in movement speed, distance and time of staying at the central region among the four groups ( P>0.05). Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the time of staying at the original platform quadrant was shortened, the apoptosis rate of hippocampal neurons was increased, and the expression of PKA, p-CREB and BDNF was down-regulated in the other three groups ( P<0.05). Compared with group CPB, the escape latency was significantly shortened, the number of crossing the original platform was increased, the time of staying at the original platform quadrant was prolonged, the apoptosis rate of hippocampal neurons was decreased, and the expression of PKA, p-CREB and BDNF was up-regulated in group CS ( P<0.05), and no significant change was found in the indexes mentioned above in group CSH ( P>0.05). Compared with group CS, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, and the time of staying at the original platform quadrant was shortened, the apoptosis rate of hippocampal neurons was increased, and the expression of PKA, p-CREB and BDNF was down-regulated in group CSH ( P<0.05). Conclusions:Sevoflurane can reduce the apoptosis in hippocampal neurons by activating PKA-CREB signaling pathway, and thus reducing the cognitive impairment induced by CPB in rats.

Application of comprehensive cognitive intervention in patients with Alzheimer's disease / 中华老年医学杂志

Alzheimer's disease is the most common cause of dementia.Current treatment options for Alzheimer's disease are very limited, and non-drug treatment is receiving more and more attention.Cognitive intervention is a relatively new non-drug treatment for Alzheimer's disease.A large number of previous studies have confirmed that cognitive intervention can prevent and mitigate clinical symptoms of Alzheimer's disease.In this review, we systematically introduce cognitive intervention as a prevention tool for Alzheimer's disease and its ability to alleviate clinical symptoms of the disease, and put forward suggestions for the future application of cognitive intervention in Alzheimer's disease.

The effect of diabetes mellitus in the elderly on memory function in patients with mild cognitive impairment / 中华老年医学杂志

Objective:To investigate the effect of diabetes mellitus in the elderly on memory function in patients with mild cognitive impairment(MCI).Methods:Totally 449 community residents were selected for a 2-year follow-up survey.Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)were selected for overall cognitive function assessment.Fuld Object Memory(FOM)and Digital Span Test(DST)were used to evaluate delayed recall and instantaneous memory.Demographic data such as gender, age, education level, marital history, annual income, blood pressure, medical history etc.were collected.The glycosylated hemoglobin, fasting insulin, and carotid artery intima-media thickness were checked regularly.All subjects were grouped into non-diabetes mellitus normal cognitive group(NDM-NC group), non-diabetes mellitus mild cognitive impairment group(NDM-MCI group), diabetes mellitus normal cognitive group(DM-NC group)and diabetes mellitus mild cognitive impairment group(DM-MCI group).Results:In cross-sectional observation, the first, second, and last recall scores in the FOM showed a decreasing trend in the DM-MCI group, showed a word "U" -shaped fluctuation trend in the DM-NC group and the NDM-MCI group, and showed no significant change in the NDM-NC group.There were no significant differences in DST anterior-backward test scores between the DM-MCI group and NDM-MCI group(all P>0.05).Through longitudinal follow-up and two-by-two comparison with the other three groups, the average value of glycosylated hemoglobin in the DM-MCI group(6.78±0.60)% was the highest, and the differences were statistically significant( P<0.05).During follow-up, the average carotid intima-media thickness(CIMT)was higher in the DM-MCI group(1.03±0.20)mm than in NDM-NC group(0.89±0.20)mm( P<0.05), and the difference was statistically significant.Comparing with the other three longitudinal follow-up groups, the CIMT thickening speed in DM-MCI group was fastest. Conclusions:Elderly DM patient population have a higher prevalence of MCI, and their memory function fluctuates or declines significantly.Therefore, regular detection of memory function is conducive to delaying the progression of DM and MCI.

Research progress on correlation between subclinical hypothyroidism and cognitive impairment / 中华老年医学杂志

Both subclinical hypothyroidism(SCH)and cognitive dysfunction are common comorbidities in the elderly.SCH is often accompanied by elevated levels of uric acid and blood lipids.It remains controversial whether SCH and cognitive dysfunction are related, and whether elevated blood uric acid and blood lipids become risk factors for cognitive impairment.This paper aims at analyzing these risk factors to explore the association of SCH with cognitive impairment, and to explore the role of high uric acid and high blood lipid levels on cognitive impairment.

Analysis of cognitive dysfunction and its influencing factors in elderly inpatients in Qinghai / 中华老年医学杂志

Objective:To evaluate the cognitive function of elderly inpatients in Qinghai and analyze the influencing factors in this prospective study.Methods:A total of 1077 elderly inpatients were enrolled for general information investigation, including the Mini Nutritional Assessment-Short form(MNA-SF), Geriatric Depression Scale 15(GDS-15), FRAIL Scale, activities of daily living(ADL), instrumental ability of daily living(IADL)and the Mini-Mental State Examination(MMSE).Results:The 1077 elderly inpatients being subjected in this study, included 470 in the cognitive impairment(CI)group and 607 in the normal group.The prevalence of CI in hospitalized elderly patients was 43.64%(470/1077). The results of univariate analysis showed that as compared with the normal group, the proportion of cognitive impairment was higher in female, elder patients, and boiling tea-drinker, otherwise the proportion of CI was lower in patients living with the spouse, normal sleep, often eating beef and mutton( P<0.01 or P<0.05); FRAIL Scale, ADL total score, and IADL total score were higher in the normal group than in the CI group( P<0.01); the elderly depression score and frailty score were higher in the CI group than in the normal group( P<0.01). The results of logistic regression analysis showed that the risk of CI was higher in female and people frequently drinking boiling tea than in male and people not frequently drinking boiling tea( OR=0.740, 1.211, both P<0.05), and that frequent consumption of beef and mutton, and reasonable levels of nutrition, ADL, and IADL were protective factors for CI in elderly hospitalized patients( OR=0.780, 0.938, 0.956, 0.895, all P<0.05). Conclusions:The incidence of cognitive impairment in hospitalized elderly patients in Qinghai is relatively high.Female and often drinking boiling tea may increase the risk of cognitive impairment.Regularly eating beef and mutton, reasonable levels of nutrition, maintaining good daily life ability can delay cognitive impairment.