Survey on the current situation for early diagnosis of dementia and contributing factors in Japan.

BACKGROUND: Early diagnosis of dementia is important for both initiation of non-pharmacological activities to slow cognitive decline as well as the development of disease-modifying drugs; however, it appears there may be a tendency for formal diagnosis to be delayed. Since the current status of diagnosis in Japan is unclear, we conducted a survey with family caregivers of patients with dementia using questionnaires and interviews to investigate the factors regarding the dementia diagnosis process in Japan. METHODS: We distributed questionnaires to family caregivers of people with dementia and conducted additional follow-up interviews with approximately half of them. We calculated odds ratios for the time to diagnosis using logistic regression analysis for each characteristic from the questionnaire data. We also created co-occurrence networks from the interview data in order to provide qualitative context to the questionnaire data. RESULTS: We collected 68 questionnaires and conducted 32 interviews. The median time to diagnosis was 12 months, and logistic regression analysis showed a significant trend toward shorter time to diagnosis in the absence of other caregivers. In addition, there were significant differences in age, relationship with patients and the time from the first visit to the final diagnosis between groups with and without other caregivers. CONCLUSIONS: The results of this study suggest that the presence or absence of other caregivers may affect caregivers' behaviour and the time taken to receive a diagnosis of dementia. These findings indicate it may be beneficial to predict inhibiting factors and change approaches based on caregivers' and patients' background to promote early diagnosis.

The Japan-Multimodal Intervention Trial for Prevention of Dementia PRIME Tamba (J-MINT PRIME Tamba): Study protocol of a randomised controlled multi-domain intervention trial.

The Japan-Multimodal Intervention Trial for Prevention of Dementia PRIME Tamba (J-MINT PRIME Tamba) is a randomised controlled trial to prevent cognitive decline in community-dwelling cognitively ordinary older people at risk of dementia. Participants are aged 65-85 years living in a rural area in Japan, aware of very mild decline in cognitive function or abilities of activities of daily living, have at least one vascular risk (e.g. hypertension or diabetes), and have a Mini-Mental State Examination score of 24 or higher. Approximately 200 participants are randomly divided into two groups, with the intervention group receiving a multi-modal intervention, including lifestyle-related disease management, physical exercise, cognitive training, and nutritional counselling, over 18 months. The primary outcome is change in the composite score of seven neuropsychological tests, including the Free and Cued Selective Reminding Test, Logical Memory I and II subsets of the Wechsler Memory Scale-Revised, and Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale. In addition, changes in a wide range of other parameters such as physical function, blood test results, sleep, and frailty are also analysed as secondary outcomes. We believe that this study's results will contribute significantly to the development of dementia prevention measures in Japan. Clinical trial registration number: UMIN000041938.

Sexual Experience Induces the Expression of Gastrin-Releasing Peptide and Oxytocin Receptors in the Spinal Ejaculation Generator in Rats.

Male sexual function in mammals is controlled by the brain neural circuits and the spinal cord centers located in the lamina X of the lumbar spinal cord (L3-L4). Recently, we reported that hypothalamic oxytocin neurons project to the lumbar spinal cord to activate the neurons located in the dorsal lamina X of the lumbar spinal cord (dXL) via oxytocin receptors, thereby facilitating male sexual activity. Sexual experiences can influence male sexual activity in rats. However, how this experience affects the brain-spinal cord neural circuits underlying male sexual activity remains unknown. Focusing on dXL neurons that are innervated by hypothalamic oxytocinergic neurons controlling male sexual function, we examined whether sexual experience affects such neural circuits. We found that >50% of dXL neurons were activated in the first ejaculation group and ~30% in the control and intromission groups in sexually naïve males. In contrast, in sexually experienced males, ~50% of dXL neurons were activated in both the intromission and ejaculation groups, compared to ~30% in the control group. Furthermore, sexual experience induced expressions of gastrin-releasing peptide and oxytocin receptors in the lumbar spinal cord. This is the first demonstration of the effects of sexual experience on molecular expressions in the neural circuits controlling male sexual activity in the spinal cord.

Why does castrated male odor attract sexually active male rats?-Attractivity induced by hypothalamus-pituitary-gonad axis block.

Sexually experienced male rats show an olfactory preference for estrous female odor compared to male odor. Notably, they also prefer castrated male over gonadally intact male odor. This study examined the role of elevated circulating gonadotropins and gonadotropin-releasing hormone (GnRH) induced by disinhibition of the hypothalamus-pituitary-gonad axis in the castration-induced attractiveness of male rats. Experiment I compared preference of sexually experienced males between odors of castrated males injected with a GnRH antagonist (Cast+Ant), castrated males injected with saline (Cast), and gonadally intact males (Sham). These olfactory preference tests revealed that probe males significantly preferred Cast over Sham and Cast+Ant odors but had no preference between Sham and Cast+Ant odors. Experiment II used hypophysectomy (HPx) to remove the gonadotropin source in place of pharmacologically antagonizing GnRH. Similarly, the probe males preferred Cast (high both GnRH and gonadotropins) over HPx (high GnRH but no gonadotropin) odors, but also preferred HPx than Sham (low both GnRH and gonadotropins) odors. We then examined the effects of exogenous gonadotropins, human chorionic gonadotropin (hCG) and equine chorionic gonadotropin (eCG), to reveal which gonadotropins critically affect on the attractiveness of HPx males. The olfactory preference tests revealed that injecting eCG, but not hCG, significantly increased the probe males` preference compared to HPx male odor, suggesting that the attractiveness is augmented via follicle stimulating hormone (FSH) receptor rather than luteinizing hormone receptor. These results indicate that sexually active male rats show olfactory preference for castrated male rats due to elevated GnRH and FSH blood levels produced by a lack of androgens.