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1.
Rev. Bras. Neurol. (Online) ; 59(4, supl.1): 22-26, out.- dez. 2023. ilus
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1552691

RESUMO

This narrative review addresses the complex relationship between neurological diseases and artistic expression, which can have a profound impact on a painter´s works. This exploration highlights the dynamic and ever-evolving connection between neuroscience and art, offering insights into the extraordinary ways in which the human brain and artistic expression intersect and evolve. Following brain damage, there may be the emergence of sudden artistic talents, intriguing changes in the styles of established artists, the paradoxical facilitation of artistic abilities despite the cognitive decline consequent to these injuries, besides coping strategies that artists adopt in response to the challenges of health. Therefore, this article investigates different scenarios where brain injuries and disorders have had a profound impact on artists, leading to the emergence of new talents, changes in artistic styles, and unexpected improvements in their work, as well as adaptations in their artistic practices, as represented by some painters such as Tommy McHugh (1949 -2012), Francisco Goya (1746-1828), Otto Dix (1891-1969), Willem de Kooning (1904-1997), William Charles Utermohlen (1933-2007) and Charles Meryon (1821-1868). Consequently, works of art can be valuable but understudied tools for understanding brain dysfunction, although they must be interpreted with great care.


Esta revisão narrativa aborda a complexa relação entre doenças neurológicas e expressão artística, que pode ter um impacto profundo na obra de um pintor. Esta exploração destaca a conexão dinâmica e em constante evolução entre a neurociência e a arte, oferecendo insights sobre as formas extraordinárias pelas quais o cérebro humano e a expressão artística se cruzam e evoluem. Após danos cerebrais, pode haver o surgimento de talentos artísticos repentinos, mudanças intrigantes nos estilos de artistas estabelecidos, a facilitação paradoxal de habilidades artísticas, apesar do declínio cognitivo consequente a essas lesões, além de estratégias de enfrentamento que os artistas adotam em resposta aos desafios de saúde. Portanto, este artigo investiga diferentes cenários onde lesões e distúrbios cerebrais tiveram um impacto profundo nos artistas, levando ao surgimento de novos talentos, mudanças nos estilos artísticos e melhorias inesperadas em seu trabalho, bem como adaptações em suas práticas artísticas, bem como representado por alguns pintores como Tommy McHugh (1949 -2012), Francisco Goya (1746-1828), Otto Dix (1891-1969), Willem de Kooning (1904-1997), William Charles Utermohlen (1933-2007) e Charles Meryon (1821-1868). Consequentemente, as obras de arte podem ser ferramentas valiosas, mas pouco estudadas, para a compreensão da disfunção cerebral, embora devam ser interpretadas com muito cuidado.

2.
Gac. méd. Méx ; 159(5): 417-425, sep.-oct. 2023. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1534469

RESUMO

Resumen Antecedentes: La información acerca del deterioro funcional después de una hospitalización por COVID-19 es limitada en personas mayores (PM). Objetivo: Determinar la asociación entre marcadores de inflamación (ferritina), coagulación (dímero D), factores clínicos y el estado funcional de PM que padecieron COVID-19 a seis meses del alta hospitalaria en México. Material y métodos: Estudio de cohorte ambispectiva de 158 pacientes mayores de 65 años hospitalizados por COVID-19 moderado-grave con expediente electrónico completo que permitiera recolectar información y contactarlos a los seis meses del alta. Se definió deterioro funcional como disminución ≥ 10 puntos del índice de Barthel. Mediante regresión logística se determinó el riesgo de asociación entre factores bioquímicos y clínicos y deterioro funcional en el tiempo de seguimiento. Resultados: 46.2 % de los participantes presentó pérdida funcional. Los factores asociados fueron edad ≥ 73 años (RM = 2.53), enfermedad renal crónica (RM = 4.57), puntuación ABC-Goals ≥ 8 (RM = 2.4), ferritina ≥ 605 ng/mL (RM = 3.94) y dímero-D ≥ 930 ng/mL FEU (RM = 17.56). Conclusión: La infección por COVID-19 no solo representa una enfermedad con alto riesgo de mortalidad durante la fase aguda, sino que también se asocia a un alto riesgo de deterioro funcional posterior al egreso hospitalario.


Abstract Background: The information on functional decline after hospitalization for COVID-19 is limited in older adults (OAs). Objective: To determine the association of inflammation (ferritin) and coagulation markers (D-dimer) and clinical factors with the functional status of OAs who suffered from COVID-19 six months after hospital discharge in Mexico. Material and methods: Ambispective cohort study of 158 patients older than 65 years hospitalized for moderate-severe COVID-19 with complete electronic records that would allow to collect information and to contact them six months after discharge. Functional impairment was defined as a decrease ≥ 10 points on the Barthel index. Using logistic regression analysis, the risk of association of biochemical and clinical factors with functional deterioration during follow-up was determined. Results: 46.2 % of participants exhibited functional decline. Associated factors included age ≥ 73 years (OR = 2.53), chronic kidney disease (OR = 4.57), an ABC-Goals score ≥ 8 (OR = 2.4), ferritin ≥ 605 ng/mL (OR = 3.94) and D-dimer ≥ 930 ng/mL (OR = 17.56). Conclusion: COVID-19 infection did not only represent a disease with a high risk of mortality during the acute phase, but is also associated with a high risk of functional impairment after hospital discharge.

3.
Artigo | IMSEAR | ID: sea-217413

RESUMO

Introduction: Obesity is on rise globally and may have a impact on cognition. Very limited research was done on the association of weight with neurocognition among the elderly. The study purpose was to determine the correlation between BMI and age with MCI and after stratifying for BMI and socio-demographic characteristics.Methods: This cross-sectional study was conducted among 576 elderly (≥60 years) in Guwahati city using a multi-stage sampling technique. Hindi Mini-Mental State Examination (HMMSE) tool was used for screening for dementia and MCI. Results: HMMSE scores were not significantly correlated with BMI (r =0.07). However, when strati-fied, a significantly negative correlation of BMI with HMMSE scores was seen for illiterates (r =-0.21), primary school education (r =-0.48) and unskilled workers (r =-0.49). There was a significant negative correlation between age and cognition for elderly belonging to OBC, (r =-0.21), Lower middle (III), (r =-0.39), Upper Lower (r =-0.17), Lower (V), (r =-0.26), Graduate, Post Graduate,(r = -0.23), Middle School, (r =-0.36), Illiterate, (r =-0.34), Clerical, (r =-0.60), Semi Professional, (r =-0.62), skilled worker (r=-0.68), Unemployed, (r =-0.15) and Obese, (r =-0.30). Conclusion: Various factors like age, category, socioeconomic status, and Body Mass Index (BMI) were found to be predictors of cognition among the elderly.

4.
Artigo | IMSEAR | ID: sea-217914

RESUMO

Background: Malnutrition is a common condition among elderly people with dementia and is associated with low nutrient and calorie intake. There are no data about efficacy of intervention with nutritional supplements in addition to medication in cognitive decline people. Aims and Objectives: we aimed to find out the nutritional status of patients with cognitive decline and to ascertain the effects of nutritional supplements with medication in such patients. Materials and Methods: This observational study was conducted for 12 months. All patients admitted with cognitive decline as per the mini-mental state examination score were included after informed consent. The demographic details, clinical features, treatment given, and response to treatment were noted and tabulated as mean ± and SD and analyzed statistically. Results: Maximum patients were found to be of moderate degree cognitive decline and were at risk of malnutrition. There was significant improvement in cognitive status and behavioral symptoms after 12 months of treatment with nutritional supplements and drugs in our study population. Conclusions: Addition of nutritional supplements to drug therapy does provides significant advantages in cognition and neuropsychiatric symptoms. They did add a lot in rectifying the deficiency of different nutritional parameters and thereby improving the domains such as nutritional functions and activity of daily living.

5.
Artigo | IMSEAR | ID: sea-216462

RESUMO

Background: Atypical presentations of acute coronary syndrome (ACS) delay its recognition and treatment in the elderly patients. Functional decline and delirium which are common to the elderly during hospitalization, leads to cognitive impairment and poor health outcomes. Steps taken for its prevention is usually not considered the top priority by the cardiologist. The present study was conducted to identify cognitive decline among elderly patients who developed ACS during hospitalization for noncardiac illness and their outcome. Materials and Methods: Three hundred and ten elderly patients above 60 years of age with ACS were included from June 26, 2020 to October 13, 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS following admission for noncardiac illness (Group II, n = 216). Co-morbidities, medications, investigations, management, clinical outcome, and Montreal Cognitive Assessment scale were compared between the two groups at the time of admission, after 30 days and after 6 months. Results: Majority of the subjects were admitted due to acute kidney injury (27.1%) in Group II and had a non-ST elevation ACS (90.2%). Optimum management was given to a lesser extent due to the clinical condition of these patients. Poor clinical outcome, cognitive impairment during hospitalization and cognitive decline during follow-up was more in Group II. Conclusion: Clinicians must be vigilant for the development of cognitive impairment and cognitive decline when an elderly patient is admitted to the hospital, as early detection and optimum management provides better clinical and cognitive outcome.

6.
China Journal of Chinese Materia Medica ; (24): 6483-6491, 2023.
Artigo em Chinês | WPRIM | ID: wpr-1008847

RESUMO

This study aims to explore the effect of preventive administration of Yigong Powder on the learning and memory abilities of the mouse model of aging induced by D-galactose and decipher the underlying mechanism, so as to provide a basis for the application of Yigong Powder in the prevention and treatment of cognitive decline. Forty KM mice were randomized into control, model, donepezil(1.5 mg·kg~(-1)), and high-dose(7.5 g·kg~(-1)) and low-dose(3.75 g·kg~(-1)) Yigong Powder groups. The mice in other groups except the control group were injected with D-galactose(200 g·kg~(-1)) at the back of the neck for the modeling of aging. At the same time, the mice were administrated with corresponding drugs by gavage for one month. Morris water maze was used to examine the learning and memory abilities of the mice. Hematoxylin-eosin staining was employed to observe the pathological and morphological changes of the hippocampus. The immunofluorescence assay was employed to detect the expression of ionized calcium-binding adapter molecule 1(IBA1), glial fibrillary acidic protein(GFAP), chemokine C-X-C-motif ligand 12(CXCL12), chemokine C-X-C-motif receptor 4(CXCR4) in the hippocampus and observe the positional relationship between IBA1, GFAP, and CXCR4. Western blot was employed to determine the protein levels of extracellular regulated kinase(ERK), p-ERK, and tumor necrosis factor receptor 1(TNFR1). Enzyme-linked immunosorbent assay was employed to measure the levels of glutamate and tumor necrosis factor(TNF-α) in the brain tissue and the level of TNF-α in the serum and spleen. Yigong Powder significantly shortened the escape latency, increased the times crossing platforms, and prolonged the cumulative time in quadrants of the aging mice. It alleviated the nerve cell disarrangement, increased intercellular space, and cell degeneration or death in the hippocampus and reduced the pathology score of the damaged nerve. Moreover, Yigong Powder reduced the positive area of IBA1 and GFAP, reduced the levels of TNF-α in the brain tissue, serum, and spleen, and decreased spleen index. Furthermore, Yigong Powder decreased the average fluorescence intensity of CXCL12 and CXCR4, reduced CXCR4-positive astrocytes and microglia, down-regulated the protein levels of p-ERK/ERK and TNFR1, and lowered the level of glutamate in the brain tissue. This study showed that the preventive administration of Yigong Powder can ameliorate the learning and memory decline of the D-galactose-induced aging mice by regulating the immune function of the spleen and the CXCL12/CXCR4 signaling in the brain to reduce glutamate release. However, the mechanism of Yigong San in preventing and treating dementia via regulating spleen and stomach function remains to be studied.


Assuntos
Camundongos , Animais , Pós , Receptores Tipo I de Fatores de Necrose Tumoral , Ácido Glutâmico , Fator de Necrose Tumoral alfa/metabolismo , Galactose/efeitos adversos , Modelos Animais de Doenças , Disfunção Cognitiva/prevenção & controle , Quimiocinas , Medicamentos de Ervas Chinesas
7.
Chinese Medical Sciences Journal ; (4): 109-116, 2023.
Artigo em Inglês | WPRIM | ID: wpr-981593

RESUMO

Objective To investigate the clinical symptoms experienced by patients with thoracic spinal tumors and verify the associated symptoms that are predictive of a decline in muscle strength in the lower limbs. Methods A single-center, retrospective cross-sectional study was conducted on in-patients diagnosed with epidural thoracic spinal tumors between January 2011 and May 2021. The study involved a review of electronic medical records and radiographs and the collection of clinical data. The differences in clinical manifestations between patients with constipation and those without constipation were analyzed. Binary logistic regression analyses were performed to identify risk factors associated with a decline in muscle strength in the lower limbs.Results A total of 227 patients were enrolled, including 131 patients with constipation and 96 without constipation. The constipation group had a significantly higher proportion of patients who experienced difficulty walking or paralysis compared to those without constipation prior to surgery (83.2% vs. 17.7%, χ2 = 99.035,P < 0.001). Constipation (OR = 9.522, 95%CI: 4.150-21.849, P < 0.001) and urinary retention (OR = 14.490, 95%CI: 4.543-46.213, P < 0.001) were independent risk factors for muscle strength decline in the lower limbs. Conclusions The study observed that patients with thoracic spinal tumors who experienced constipation symptoms had a higher incidence of lower limb weakness. Moreover, the analysis revealed that constipation and urinary retention were independent risk factors associated with a preoperative decline in muscle strength of lower limbs.


Assuntos
Humanos , Constipação Intestinal/etiologia , Estudos Transversais , Extremidade Inferior , Força Muscular , Estudos Retrospectivos , Neoplasias da Coluna Vertebral , Retenção Urinária
8.
Journal of Biomedical Engineering ; (6): 573-581, 2023.
Artigo em Chinês | WPRIM | ID: wpr-981578

RESUMO

China is facing the peak of an ageing population, and there is an increase in demand for intelligent healthcare services for the elderly. The metaverse, as a new internet social communication space, has shown infinite potential for application. This paper focuses on the application of the metaverse in medicine in the intervention of cognitive decline in the elderly population. The problems in assessment and intervention of cognitive decline in the elderly group were analyzed. The basic data required to construct the metaverse in medicine was introduced. Moreover, it is demonstrated that the elderly users can conduct self-monitoring, experience immersive self-healing and health-care through the metaverse in medicine technology. Furthermore, we proposed that it is feasible that the metaverse in medicine has obvious advantages in prediction and diagnosis, prevention and rehabilitation, as well as assisting patients with cognitive decline. Risks for its application were pointed out as well. The metaverse in medicine technology solves the problem of non-face-to-face social communication for elderly users, which may help to reconstruct the social medical system and service mode for the elderly population.


Assuntos
Idoso , Humanos , Disfunção Cognitiva/prevenção & controle , Envelhecimento , China , Internet , Tecnologia
9.
Chinese Journal of Physical Medicine and Rehabilitation ; (12): 320-325, 2023.
Artigo em Chinês | WPRIM | ID: wpr-995201

RESUMO

Objective:To observe any effect of virtual reality (VR) training on the cognitive functioning and functional fitness of nursing home residents with subjective cognitive decline (SCD).Methods:Fifty-six of such residents were randomly divided into an observation group and a control group, each of 28. Both groups received health education and routine care, but the observation group was additionally provided with 45 minutes of VR training three times a week for 6 months. The training included Baduanjin, magic, flying bird, supermarket shopping, gravity ball and gym episodes. Both groups′ cognition was evaluated using the subjective cognitive decline questionnaire (SCD-Q), the Montreal cognitive assessment (MoCA), the Rivermead Behavioural Memory Test (second edition) (RBMT-Ⅱ), a digit symbol substitution test (DSST), an animal fluency test (AFT) and trail-making test A-B (TMT A-B). Functional fitness was quantified using the 8-foot up-and-go test (8UGT), a 30-second arm curl test (30sACT), a 30-second chair stand test (30sCST), a back scratching test (BST), the sit-and-reach test (CSRT) and a 2-minute step test (2MST) before and after the 6-month intervention.Results:After the intervention, the average SCD-Q, MoCA, RBMT-Ⅱ, DSST, TMT-A, and TMT-B scores of the observation group were significantly better than before the intervention, and significantly better than the control group′s averages. And except for the back scratching their functional results were also significantly better, on average, than those of the control group.Conclusions:VR training can effectively improve the cognition and functional fitness of nur-sing home residents with SCD. Such training is worthy of promotion and wider application in nursing homes.

10.
Journal of Environmental and Occupational Medicine ; (12): 239-245, 2023.
Artigo em Chinês | WPRIM | ID: wpr-969626

RESUMO

Background Occupational aluminum exposure may associate with cognitive impairment in workers. At present, brain functional imaging data are not available for evaluating cognitive dysfunction in workers with occupational exposure to aluminum. The role of brain functional connectivity in cognitive decline associated with occupational aluminum exposure is not clear yet. Objective To explore potential mediating effect of brain functional connectivity value on cognitive decline induced by occupational aluminum exposure, to assess the relationship between cognitive impairment and brain functional connectivity, and to identify appropriate imaging evidence of early cognitive changes induced by occupational aluminum exposure. Methods This study used a subset data from a previous cross-sectional survey. Based on the data of aluminum-exposed workers, over 40 years old, aluminum-exposed working years >1 year, Montreal International Cognitive Assessment (MoCA) (Beijing version) score <26 points, 20 workers were selected as the case group, and 40 healthy workers with the same basic conditions (age, smoking, drinking, etc.) in non-aluminum production were selected as the control group with a 1∶2 matching ratio. The basic information of the subjects was collected, plasma aluminum level and cognitive function level were evaluated, and different brain functional connectivity values of default mode network (DMN) were measured by magnetic resonance imaging. The mediating effect analysis was conducted to examine the role of brain functional connectivity in the relationship between aluminum exposure and cognitive function. Results The plasma aluminum concentration of the case group was 1.76 times higher than that of the control group [(33.04±12.02) µg·L−1 vs (18.74±8.95) µg·L−1, P<0.05]; the MoCA score was 9.5 points lower [(18.35±2.64) vs (27.85±0.92), P<0.05]. The mean functional connection values of DMN1 and DMN2 in the case group were lower than those in the control group (P<0.05). The mean functional connection values of the left precuneus, left middle cingulate cortex, left superior medial gyrus, left precentral gyrus, and left cerebellum also decreased in the case group compared with the control group (P<0.05). Plasma aluminum concentration was negatively correlated with DMN1 functional connectivity value and MoCA scores (b=−0.004, 95%CI: −0.008–−0.001; b=−0.15, 95%CI: −0.233–−0.067; P<0.05). The mean functional connection values of DMN1 and DMN2 were positively correlated with MoCA scores (b=10.945, 95%CI: 5.574–16.316; b=10.107, 95%CI: 2.457–17.758; P<0.05). With the increase of plasma aluminum concentration, MoCA score decreased, but when the plasma aluminum concentration exceeded 19.50 µg·L−1, MoCA score decreased slowly. With the increase of the mean functional connectivity value of DMN1, MoCA score increased, but when the mean functional connectivity value of DMN1 exceeded 1.05 and continued to increase, the increase of MoCA score slowed down. The results of mediating effect analysis showed that the functional connectivity value of DMN1 partially mediated the relationship between plasma aluminum concentration and MoCA score, and the mediating effect was 25.80%. Conclusion Cognitive impairment in occupational aluminum-exposed workers is closely related to brain resting-state functional connectivity. There is a dose-response relationship of plasma aluminum concentration with DMN1 functional connectivity value and MoCA scores, and DMN1 functional connectivity value partially mediates the relationship between plasma aluminum concentration and MoCA scores. The brain functional connectivity value can be used as meaningful imaging data to study the cognitive decline induced by chronic aluminum exposure.

11.
Journal of Southern Medical University ; (12): 225-231, 2023.
Artigo em Chinês | WPRIM | ID: wpr-971519

RESUMO

OBJECTIVE@#To explore the association between depressive symptoms and the risks of rapid decline in renal function and chronic kidney disease (CKD) in middle-aged and elderly with normal kidney function.@*METHODS@#The residents aged 40- 75 years with eGFR≥60 mL·min-1·1.73 m-2 without proteinuria in Lanzhou region, who participated in the "REACTION" study carried out in 2011, were selected and followed up in 2014. A total of 4961 individuals with complete and qualified data from the two surveys were included in the subsequent analysis. Based on PHQ-9 questionnaire scores, the baseline population was divided into two groups with and without depressive symptoms. Cox proportional hazard analysis was used to compare the incidences of rapid renal function decline and CKD between the two groups and study the association of depressive symptoms with the risk of these renal conditions.@*RESULTS@#PHQ-9 questionnaire scores were not found to correlate with baseline SCr, ALB, UACR or eGFR levels among the participarts (P>0.05). After a mean follow-up time of 3.4±0.6 years, 33.9% of the participants with depressive symptoms at baseline experienced a rapid decline in renal function and 3.6% progressed to CKD. During the follow-up, the incidence of rapid decline in renal function and the risk of developing CKD were not found to correlate with depressive symptoms in these participants (P>0.05) regardless of the type of the depressive syndromes.@*CONCLUSION@#Depressive symptoms are not associated with the risks of rapid renal function decline or progression to CKD in middle-aged and elderly with normal kidney function.


Assuntos
Idoso , Pessoa de Meia-Idade , Humanos , Estudos de Coortes , Depressão , Taxa de Filtração Glomerular , Progressão da Doença , Insuficiência Renal Crônica/epidemiologia , Rim/fisiologia , Fatores de Risco
12.
Shanghai Journal of Preventive Medicine ; (12): 963-969, 2023.
Artigo em Chinês | WPRIM | ID: wpr-1003481

RESUMO

ObjectiveTo investigate the relationship between e-cigarette use and subjective cognitive decline. MethodsThis study included survey participants aged ≥45 years from the US Behavioral Risk Factor Surveillance System. The prevalence of subjective cognitive decline in people with different tobacco use conditions was estimated. Multivariate logistic regression was employed to determine the relationship between e-cigarette use and subjective cognitive decline, as well as the relationship between co-use of e-cigarette and combustible tobacco and subjective cognitive decline. ResultsA total of 204 032 participants were included in the study. The total prevalence of subjective cognitive decline was 11.46%, whereas among current e-cigarette users, the prevalence was 19.92%. After accounting for confounding factors, current e-cigarette use was identified as a risk factor for subjective cognitive decline compared to individuals who had never used e-cigarettes, with an OR of 1.46 (95%CI: 1.20‒1.77). Meanwhile, occasional e-cigarette use showed a higher risk, with an OR of 1.54 (95%CI: 1.22‒1.95). The highest risk was observed with the co-use of e-cigarette and combustible tobacco, with an OR of 1.69 (95%CI: 1.32‒2.16), followed by current e-cigarette use and former combustible tobacco use, with an OR value of 1.38 (95%CI: 1.08‒1.78). ConclusionThe use of e-cigarettes increases the risk of subjective cognitive decline, with occasional use demonstrating a more pronounced negative impact. In general, the risk of cognitive decline is greater among e-cigarette users compared to combustible tobacco users. Controlling the use of combustible tobacco, especially e-cigarette, will help reduce the incidence of subjective cognitive decline. Individuals currently using combustible tobacco are advised to explore smoking cessation methods other than transitioning to e-cigarettes.

13.
Chinese Journal of Health Management ; (6): 25-28, 2023.
Artigo em Chinês | WPRIM | ID: wpr-993640

RESUMO

Objective:To analyze the correlation between ambulatory blood pressure variability and the progression of subjective cognitive decline (SCD).Methods:In this prospective observational study, the overall sampling method was used to continuously select 100 patients with SCD in the Department of Neurology, Changshu First People′s Hospital and Changshu Xinzhuang People′s Hospital from January 1 2016 to June 30 2017. The baseline demographic characteristics of the patients were collected. The Chinese version of SCD-Q9 questionnaire was used to self-evaluate SCD, and the Montreal Cognitive Assessment Scale (MoCA) was used to evaluate objective cognitive impairment. All patients received 24 h ambulatory blood pressure monitoring, and 24 h systolic coefficient of variation (SCV) and diastolic coefficient of variation (DCV) were calculated. The follow-up period was 4 years after the first visit, and the MoCA scale was evaluated once a year. Finally, 83 patients completed the follow-up and were included in this study. According to the MoCA score at the end of follow-up (<26 or ≥26), the patients were divided into progression group (39 cases) and non-progression group (44 cases). The difference of MoCA score between baseline and last follow-up was calculated in the progression group. The difference in demographic characteristics between the two groups was compared with χ2 test. The difference of 24 h SCV and 24 h DCV between the two groups were compared by rank sum test. The correlation between 24 h SCV and MoCA score difference or SCD-Q9 score in the progression group were tested by multiple linear regression analysis. Results:The 4-year progression rate of SCD patients was 46.99% (39/83). There was no significant differences in baseline age, gender, education level, medical history, smoking history, SCD-Q9 score and MoCA score between the progressive group and the non-progressive group (all P>0.05). The 24 h SCV in the progressive group was significantly higher than that in the non-progressive group [13.4% (9.9%, 15.6%) vs 10.9% (9.7%, 12.7%), U=594.50, P=0.016]. There was no significant difference in 24 h DCV between the two groups ( P>0.05). In progressive group, the 24 h SCV was negatively correlated with MoCA score difference ( r=-0.368, P=0.021). Conclusion:There is a correlation between ambulatory blood pressure variability and SCD progression, high 24 h SCV may be one of the factors of SCD progression and has certain predictive value.

14.
Chinese Acupuncture & Moxibustion ; (12): 1379-1383, 2023.
Artigo em Inglês | WPRIM | ID: wpr-1007497

RESUMO

OBJECTIVES@#To observe the effects on cognitive function, sleep quality and hemodynamics in the patients with subjective cognitive decline (SCD) after treated with acupuncture at neck-Jiaji (EX-B 2) and tuina on the base of healthy lifestyle education and meta-memory training.@*METHODS@#Sixty SCD patients were randomly divided into an observation group (30 cases, 1 case dropped out) and a control group (30 cases, 3 cases dropped out). In the control group, the healthy lifestyle education and meta-memory training was performed, twice daily, 15 min each time; the 5-day intervention was delivered a week, lasting consecutively 4 weeks. On the base of the intervention as the control group, in the observation group, acupuncture at neck-Jiaji (EX-B 2) and tuina was conducted. First, one-finger pushing and plucking method of tuina was exerted on the neck region along the running courses of the bladder meridian of foot-taiyang and the governor vessel, for 10 min to 15 min; afterwards, acupuncture was delivered at bilateral neck-Jiaji (EX-B 2), from C1 to C7; and the needles were retained for 30 min. This intervention was given once daily, 5 times a week, for consecutive 4 weeks. Before and after treatment, the score of the mini-mental state examination (MMSE), the score of full scale memory quotient (FSMQ) were assessed by Wechsler memory scale-fourth edition (WMS-Ⅳ) and the score of the Pittsburgh sleep quality index (PSQI) was compared between the two groups. Using transcranial Doppler ultrasound, the hemodynamic indexes (the mean velocity [Vm] and pulsatility index [PI] of the left vertebral artery [LVA], the right vertebral artery [RVA] and the basilar artery [BA]) were determined in the two groups.@*RESULTS@#After treatment, the scores of MMSE and FSMQ increased compared with those before treatment in the two groups (P<0.05, P<0.001), PSQI score was lower (P<0.05) and Vm of BA was higher (P<0.001) in the observation group when compared with those before treatment. The scores of MMSE and FSMQ, as well as Vm of BA were higher (P<0.05, P<0.001), and PSQI score was decreased (P<0.05) in the observation group when compared with the control group.@*CONCLUSIONS@#The combined therapy of acupuncture at neck-Jiaji (EX-B 2) and tuina is more advantageous to improving cognitive function, relieving chronic emotional stress and ameliorating sleeping quality in the patients with subjective cognitive decline, which may be achieved by improving the blood supply of the basilar artery.


Assuntos
Humanos , Terapia por Acupuntura/métodos , Clorofenóis , Disfunção Cognitiva/terapia , Cognição , Pontos de Acupuntura , Resultado do Tratamento
15.
Journal of Sun Yat-sen University(Medical Sciences) ; (6): 115-121, 2023.
Artigo em Chinês | WPRIM | ID: wpr-961837

RESUMO

ObjectiveAutonomic dysfunction is a common and serious complication in patients with early chronic kidney disease (CKD). Sweat gland dysfunction is an initial sign of autonomic dysfunction. Electrochemical skin conductance (ESC) measurement by reverse iontophoresis and chronoamperometry to assess sweat gland function may detect patients with mild renal insufficiency in healthy population for early intervention and treatment to delay further deterioration of renal function. MethodsAn EZSCAN score (0~100) was calculated using a proprietary algorithm based on the chronoamperometry analysis. A total of 6 661 subjects who received physical examination from the physical examination center of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to October 2020 were enrolled, including 2 075 (31.15%) subjects with reduced renal function (eGFR < 90 mL·min-1·1.73 m-2) as the case group and 4 586 (68.85%) subjects with normal renal function (90 mL·min-1·1.73 m-2≤ eGFR ≤120 mL·min-1·1.73 m-2) as the control group. Lasso regression was used to screen covariates, and the relationship between the risk score and eGFR was analyzed by loess curve and logistic regression. ResultsAfter multivariate adjustment, the risk score was correlated with the risk of eGFR decline. Compared with the group with the lowest risk value (Q1<24), the OR(95%CI )of Q2 (25-27), Q3 (28-47), and Q4 (48-75) were 1.85 (1.55, 2.21), 2.53 (2.13, 3.00), 2.49 (2.13, 2.93), respectively. The maximum area under the ROC curve is 0.75(0.74,0.76), the sensitivity is 73.98%, the specificity is 63%, the positive predictive value is 47.49%, the negative predictive value is 84.25%, and the Youden index is 0.369 72, the optimal cutoff value is 25. ConclusionsEZSCAN could be a useful screening tool to identify healthy individuals at increased risk of renal function decline, and the one with an EZSCAN score of more than 25% should undergo diagnostic laboratory testing.

16.
Biomedical and Environmental Sciences ; (12): 231-240, 2023.
Artigo em Inglês | WPRIM | ID: wpr-970312

RESUMO

OBJECTIVE@#To evaluate the association between serum uric acid (SUA) and kidney function decline.@*METHODS@#Data was obtained from the China Health and Retirement Longitudinal Study on the Chinese middle-aged and older population for analysis. The kidney function decline was defined as an annual estimated glomerular filtration rate (eGFR) decrease by > 3 mL/min per 1.73 m 2. Multivariable logistic regression was applied to determine the association between SUA and kidney function decline. The shape of the association was investigated by restricted cubic splines.@*RESULTS@#A total of 7,346 participants were included, of which 1,004 individuals (13.67%) developed kidney function decline during the follow-up of 4 years. A significant dose-response relation was recorded between SUA and the kidney function decline ( OR 1.14, 95% CI 1.03-1.27), as the risk of kidney function decline increased by 14% per 1 mg/dL increase in SUA. In the subgroup analyses, such a relation was only recorded among women ( OR 1.22, 95% CI 1.03-1.45), those aged < 60 years ( OR 1.22, 95% CI 1.05-1.42), and those without hypertension and without diabetes ( OR 1.22, 95% CI 1.06-1.41). Although the dose-response relation was not observed in men, the high level of SUA was related to kidney function decline ( OR 1.83, 95% CI 1.05-3.17). The restricted cubic spline analysis indicated that SUA > 5 mg/dL was associated with a significantly higher risk of kidney function decline.@*CONCLUSION@#The SUA level was associated with kidney function decline. An elevation of SUA should therefore be addressed to prevent possible kidney impairment and dysfunction.


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China/epidemiologia , População do Leste Asiático , Taxa de Filtração Glomerular , Rim/fisiopatologia , Estudos Longitudinais , Fatores de Risco , Ácido Úrico/sangue
17.
Artigo em Espanhol | LILACS | ID: biblio-1438380

RESUMO

En los últimos años, ha existido un interés creciente por entender la naturaleza del lenguaje en el envejecimiento normal. Existen diversas investigaciones y teorías que exponen los cambios que se producen en los diferentes niveles del lenguaje, a saber, nivel morfosintáctico, fonológico, léxico, discursivo. Estos cambios estarían relacionados con el declive de la memoria operativa y la velocidad de procesamiento. La necesidad de realizar una revisión bibliográfica teórica sobre esta temática se sustenta en dos razones esenciales, la primera es la trascendencia de la comunicación y del lenguaje para el individuo; la segunda se centra en cambiar la mirada de la declinación de la capacidad comunicativa a buscar las posibilidades y alternativas para conservarla. El objetivo de este trabajo fue describir los cambios asociados con la edad en el lenguaje y buscar estrategias para preservar el mismo. Se proponen diversas actividades que estimulen la neuroplasticidad neuronal y aumenten la reserva cognitiva en los adultos mayores. Las mismas tienen como objetivo trabajar sobre los déficits descritos anteriormente y que han sido propuestos como responsables del declive de los distintos niveles del lenguaje.


In recent years, there has been a growing in understanding the nature of language in normal aging. There are varios investigations and theories that expose the changes that occur at different levels of language: morphosyntactic, phonological, lexical, discursive level. These changes would be related to the decline of working memory and processing speed. The need to carry out a theoretical bibliographic review on this subject is based on two essential reasons, the first is the importance of communication and language for the human; the second focuses on changing the perspective of the fall of communicative capacity to search for possibilities and alternatives to preserve it. The objective of this work was to describe the changes associated with age in language and to search strategies to preserve it. Various activities are proposed to stimulate neuronal neuroplasticity and increase cognitive reserve in older adults. They aim to work on the déficits described aove and that have been proposed as responsable for the decline of the different levels of language.


Assuntos
Humanos
18.
Indian Heart J ; 2022 Dec; 74(6): 505-509
Artigo | IMSEAR | ID: sea-220953

RESUMO

Atrial fibrillation (AF) confers a 2-to-3-fold increased risk of developing cognitive dysfunction and dementia, independent of age and past stroke. The purpose of study was to identify risk factors for developing dementia amongst AF patients in India. This was a single-centre, prospective, observational study wherein recently diagnosed, treatment naïve, persistent non-valvular AF patients were enrolled. All patients were screened for dementia using the Mini-Mental state exam. Amongst a total of 108 patients enrolled, 40 (37%) had dementia. The most common cognitive deficits were in attention and calculation followed by memory deficits. Factors independently contributing to dementia were advanced age, female sex, presence of diabetes, elevated pulmonary artery pressures and a lower serum albumin.

19.
Artigo | IMSEAR | ID: sea-225797

RESUMO

Background:Parkinson disease(PD)is one of the most common age-related brain disorders, with cardinal symptoms rigidity, bradykinesia, resting tremor and postural instability. These aredopamine-related motor symptoms.PD is increasingly recognized as heterogeneous multisystem disorder involving other neurotransmitter associated with nonmotor symptoms. In whichcognitive decline is the most common and important NMS. cognitive decline in PD makes profound effect on patient quality of life and imposes significant burden on the caregiver.Methods:Hospital based cross sectional study conducted among 52 patients of idiopathic Parkinson disease, 61 to 80 years of age (fulfilling UKPDS brain bank criteria) at GSVM medical college, Kanpur during February 2020 to October2021 using SCOPA COG scale.Results:Using SCOPA COG score in 52 patients,17 (33%) patients foundwith declined cognition There was weak negative correlation betweentotal score and duration of illness(p=0.091), weak negative correlation between executive function (assessed by dice) and duration of illness (p=0.047)and a moderate negative correlationbetween visuospatial function (assessed by assembling pattern) and duration of illness (p=0.003).Conclusions:Significant cognitive decline found with increase in duration of illness in terms of visuospatial function.

20.
Rev. colomb. cardiol ; 29(2): 162-169, ene.-abr. 2022. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1376874

RESUMO

Abstract Introduction: Polypharmacy and cognitive decline are both common problems in the elderly. Objective: To determine the relationship between polypharmacy and cognitive status among elderly with cardiovascular disease. In this cohort study, 120 older people with polypharmacy and the same number non-polypharmacy were selected from Clinics in Sari Heart Center, Iran, according to inclusion criteria between October 2019 and January 2020. Materials and method: Data collection tools included Cognitive State Test (COST) and Geriatric Oral Health Assessment Index, Geriatric Depression Scale, Anatomic Therapeutic Chemical drug questionnaire, and a medical-demographic questionnaire. Data were analyzed using the χ2 test, independent t-test, logistic, and linear regression test. Results: Mean age of poly-pharmacy and non-poly pharmacy groups was 67.63 ± 6.67 and 66.09 ± 6.21 21 years, respectively (p = 0.065). Women ratio was significantly more among the poly-pharmacy group, compared to non-polypharmacy (p = 0.007). The odds ratio of cognitive decline increased by 3.17 times with poly-pharmacy (95% confeind intervel: 2.48-4.05). The most predictors of cognition were polypharmacy, income, hypertension, and gender, respectively. The predictive power of the model was 48.9%. Conclusion: Regarding the significant relationship between poly-pharmacy and cognitive status, it should be considered as one of the approaches to increase the cognitive status among older adults. Furthermore, it is necessary to emphasize on the factors affecting cognitive status among older people in programs, to improve the medical and health services for them.


Resumen Introducción: Tanto la polifarmacia como el deterioro cognitivo son problemas comunes entre los adultos mayores. Objetivo: Establecer la relación entre la polifarmacia y el estado cognitivo de los adultos mayores con enfermedad cardiovascular. En este estudio de cohorte se seleccionaron 120 adultos mayores con polifarmacia e igual número sin polifarmacia de las clínicas en Sari Heart Center, Irán, de acuerdo con los criterios de inclusión, entre octubre del 2019 y enero del 2020. Materiales y método: Las herramientas de recolección de datos incluyeron el Cognitive State Test (COST) y Geriatric Oral Health Assessment Index (GOHAI), el Geriatric Depression Scale, el cuestionario de medicamentos Anatomic Therapeutic Chemical (ATC), y un cuestionario médico-demográfico. Los datos se analizaron con la prueba de Chi-cuadrado, la prueba t para muestras independientes, y pruebas de regresión logística y lineal. Resultados: La edad media de los grupos con y sin polifarmacia fue de 67,63± 6,67 y 66,09 ± 6,21 años, respectivamente (p = 0.065). La proporción de mujeres fue significativamente más alta en el grupo con polifarmacia comparada con el grupo sin polifarmacia (p = 0.007). La razón de disparidad del deterioro cognitivo aumentó 3,17 veces con la polifarmacia (IC 95%: 2,48 y 4,05). Los mayores predictores de cognición fueron la polifarmacia, los ingresos, la hipertensión y el género, respectivamente. El poder predictivo del modelo fue de 48,9%. Conclusión: Respecto a la relación significativa entre la polifarmacia y el estado cognitivo, se debe considerar como uno de los abordajes para aumentar el estado cognitivo en los adultos mayores. También es necesario enfatizar en los factores que afectan el estado cognitivo de los adultos mayores participantes en los programas, para mejorar los servicios médicos y de salud dirigidos a ellos.

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