Relationship between neuropsychiatric symptoms and cognitive functions in patients with cognitive impairment.

BACKGROUND: Cognitive decline and neuropsychiatric symptoms (NPS) are main clinical manifestations in Alzheimer disease (AD). It is unclear whether the link between specific NPS and cognitive domains exists in AD or mild cognitive impairment (MCI). Our study aimed to examine the association between specific cognitive domain and NPS in AD and MCI, and to evaluate whether this association showed variety in different stages of cognitive impairment. METHODS: A total of 458 patients diagnosed as AD or MCI were included in this study. Neuropsychological batteries were applied in the study. The association between NPS and cognitive function were evaluated by multiple linear regression, and its correlation was evaluated by Spearman correlation coefficient. RESULTS: The prevalence of NPS increased with the severity of cognitive impairment, and there were significant differences between MCI and AD. NPS were predominantly associated with cognitive domains, including memory, language, attention, and executive function. Both regression liner analysis and correlation analysis showed delusion, hallucination, and aberrant motor behaviour (AMB) were linked to language and attention. In addition, regression liner analysis illustrated depression, anxiety, and apathy were related to learning and episodic memory. Generally, the delusion, hallucination, and AMB have the broadest impact on cognition. CONCLUSION: Specific NPS was predominantly associated with different cognitive domains. Symptoms of agitation, delusion and irritability indicate worse cognitive performance. Therefore, cognitive improvement should be a therapeutic strategy in managing NPS in AD.

The prevalence and clinical risk factors of insomnia in the Chinese elderly based on comprehensive geriatric assessment in Chongqing population.

BACKGROUND: Insomnia is a major public health problem affecting older people. This study aimed to investigate the prevalence and clinical risk factors of insomnia in a representative sample of Chinese elderly (≥ 60 years) in Chongqing. METHODS: A cross-sectional study based on comprehensive geriatric assessment was conducted from January 2013 to February 2014. A questionnaire on sleep status was provided to each patient and insomnia was assessed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria. A multivariate logistic regression model was used to illustrate risk factors correlated with insomnia. RESULTS: Of the total 597 participants, 55.4% suffered from insomnia. The prevalence of insomnia in men and women was 48.2% and 63.2%, respectively. Coronary heart disease, dizziness, chronic pain, anorexia, malnutrition, depression and cognitive decline were identified as risk factors associated with insomnia. Hypertension, diabetes, hyperlipidaemia, headache, age and education level were not observed to be significantly associated with insomnia. CONCLUSIONS: Insomnia is highly prevalent among the elderly in Chongqing, and shows a positive correlation to coronary heart disease, dizziness, chronic pain, anorexia, malnutrition, depression, cognitive impairment. Moreover, women are more likely to experience insomnia than men.

Clinical characteristics and the diagnosis and treatment status of headaches in the Department of Gerontology of a university hospital in China.

Headache is a common problem among the population, many factors may impact the headache characteristics and medical consultation behaviors in different age groups. The purpose of this study was to evaluate the clinical characteristics and the diagnosis and treatment status of headaches in elderly patients hospitalized in a gerontologic department. Consecutive patients hospitalized in the Department of Gerontology eligible for this study were registered. All the patients underwent a comprehensive evaluation of their whole health status, performed by three gerontologists initially. Then headache was evaluated by two physicians experienced in headache studies. Headache diagnosis was made according to the criteria of the second edition of the International Classification of Headache Disorders. In this study, 20% of the participants reported at least one headache attack in the previous year. Sixty percent of the migraineurs and 79·7% of the tension type headache (TTH) patients reported bilateral pain. Throbbing/pulsating and tightness/pressing were the most frequently described pain quality by the migraineurs and TTH patients, respectively. The migraineurs reported the most severe pain (P < 0·001). The frequency of headache attacks was not significantly different in the three subgroups (P  =  0·053). About 76·2% of the migraineurs, 68·8% of the TTH, and 80% of the other type headache patients had consulted a physician for their headaches in the previous year. Taking acute analgesics for headache was more common in migraineurs (P < 0·001). The results showed that headache remained under-recognized and under-treated in the geriatrics department.

Vascular risk factors and mild cognitive impairment in the elderly population in Southwest China.

OBJECTIVES: Increasing evidence has demonstrated that vascular risk factors (VRFs) contribute to cognitive impairment in the elderly population. Prevention and administration of VRFs can be a vital strategy for delaying cognitive impairment. This study aimed to determine the impact of VRFs on cognitive function of the aged people from Chongqing, Southwest China. METHODS: A total of 597 participants (≥60 years) from hospital and community population were enrolled in the cross-sectional study. Participants were screened for hypertension, coronary heart disease (CHD), and cerebrovascular disease (CVD). Blood pressure (BP) and blood lipid were also measured. Cognitive function was assessed with Mini-Mental State Examination and Clinical Dementia Rating. Logistic regression analysis was used to look for VRFs impacting mild cognitive impairment (MCI). Then we investigated the relationship between different types of vascular diseases and MCI. RESULTS: A total of 457 participants showed normal cognitive function and 140 participants showed MCI. After adjusting for age, gender, and education, logistic regression analysis demonstrated that hypertension, CHD, systolic BP, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) were independently associated with MCI; however, CVD, diastolic BP, triglyceride, and high-density lipoprotein cholesterol were not associated with MCI. Moreover, vascular diseases significantly contributed to MCI compared with no vascular disease; however, no significant difference in incident MCI was found among different combinations of vascular diseases. CONCLUSIONS: Hypertension, CHD, TC, and LDL-C are independent risk factors for MCI. Moreover, patients with vascular diseases have a higher risk of MCI; however, the amount of vascular diseases does not increase the risk of MCI.

Hypoxia-up-regulated mitochondrial movement regulator does not contribute to the APP/PS1 double transgenic mouse model of Alzheimer's disease.

BACKGROUND/AIMS: It has been demonstrated that mitochondrial dysfunction is associated with Alzheimer's disease (AD); meanwhile, hypoxia-up-regulated mitochondrial movement regulator (HUMMR) plays an important role in regulating mitochondrial function. The present study aimed to confirm the association between HUMMR and mitochondrial function in AD. METHODS: We detected the expression of HUMMR at transcriptional and translational levels in APP/PS1 double transgenic mice using real-time quantitative RT-PCR and Western blotting. Age- and gender-matched wild-type (WT) littermates were used as controls. Mitochondrial morphology was observed in the hippocampus and cortex of APP/PS1 double transgenic mice using transmission electron microscopy. RESULTS: Damage to mitochondrial morphology in the hippocampus and cortex of APP/PS1 double transgenic mice was found, including swelling and cavitations. Our analysis showed no statistical differences in the expression of HUMMR between APP/PS1 double transgenic mice and WT littermates (p > 0.05). These results showed that there was no association between HUMMR and mitochondrial dysfunction in APP/PS1 transgenic mice. CONCLUSION: These results indicate that HUMMR does not play a key role in mitochondrial dysfunction in the APP/PS1 double transgenic AD mouse.

Expression pattern of sorting Nexin 25 in temporal lobe epilepsy: a study on patients and pilocarpine-induced rats.

PURPOSE: The transforming growth factor ß (TGF-ß) signaling pathway is involved in the epileptogenesis. Sorting Nexin 25 (SNX25) has been recently proposed to modulate TGF-ß signaling through endosomal sorting of TGF-ß receptors for lysosomal degradation. The aim of the present study was to determine the expression pattern of SNX25 in brains of epilepsy patients and in animal model of epilepsy. METHODS: We investigated the expression of SNX25 in the brain tissues of patients with temporal lobe epilepsy (TLE) and in the pilocarpine-induced rat model of epilepsy using western blotting, real-time quantitative RT-PCR, and double-label immunofluorescence. RESULTS: The expression of SNX25 was significantly increased in TLE patients in comparison to controls (0.21±0.07 vs. 0.11±0.03, P<0.05). In the lithium-pilocarpine induced epileptic rats, significant elevation of SNX25 levels was detected in the chronic phase, while no SNX25 alteration occurred in the acute and latent phases. Moreover, SNX25 localized to astrocytes and neurons, in both human samples and animal models. CONCLUSION: Our results indicate that upregulation of SNX25 might be involved in the development of temporal lobe epilepsy.