Correlation of dietary inflammation index and dietary pattern with mild cognitive impairment in patients with type 2 diabetes.

OBJECTIVE: We aimed to determine the dietary patterns associated with mild cognitive impairment (MCI) in type 2 diabetes (T2DM) and the correlation of dietary inflammatory index (DII) with MCI. METHODS: The Montreal Cognitive Assessment (MoCA) was used to assess cognitive function. A semi-quantitative food frequency questionnaire was used to collect dietary data and calculate DII. Dietary patterns were determined by reduced-rank regression (RRR), grouping dietary pattern scores and DII into quartiles, with logistic regression for correlation analysis. Dose-response relationships between dietary pattern scores, DII and diabetic MCI were explored using restricted cubic splines (RCS). A mediation analysis was performed to investigate whether DII mediates the association between dietary patterns and MCI. RESULTS: In the "Mediterranean-style dietary pattern", the multivariable-adjusted odds ratio of having MCI was 0.37 (95% CI: 0.20-0.68; p for trend=0.002) in the highest versus lowest quartiles of the dietary score. In the "high-meat and low-vegetable pattern", the multivariable-adjusted odds ratio of having MCI was 6.84 (95% CI: 3.58-13.10; p for trend<0.001) in the highest versus lowest quartiles of the dietary score. In the "Western-style dietary pattern", the multivariable-adjusted odds ratio of having MCI was 2.48 (95% CI: 1.38-4.46; p for trend=0.001). The multivariable-adjusted odds ratio of having MCI was 3.99 (95% CI: 2.14-7.42; p for trend<0.001) in the highest versus lowest quartiles of DII. There is a non-linear dose-response relationship between the "high-meat and low-vegetable pattern" score and the prevalence of MCI, as well as the DII and the prevalence of MCI. The DII partially mediated the impact of the "Mediterranean-style dietary pattern" and the "high-meat and low-vegetable pattern" on MCI. CONCLUSION: In T2DM patients, greater adherence to the "Mediterranean-style dietary pattern" is associated with a lower probability of having MCI. However, excessive consumption of meat, especially red meat and processed meat, combined with a lack of vegetable intake, is associated with a higher probability of having MCI. Greater adherence to the "Western-style dietary pattern" is associated with a higher probability of having MCI. In addition, a pro-inflammatory diet is associated with a higher probability of having MCI, and DII partially mediates the impact of dietary patterns on MCI.

Effect of probiotics on cognitive function in adults with mild cognitive impairment or Alzheimer's disease: A meta-analysis of randomized controlled trials.

BACKGROUND: Recent clinical studies have yielded controversial results regarding the effect of probiotics on cognitive function in Alzheimer's disease (AD) or mild cognitive impairment (MCI) subjects. To clarify the efficacy of probiotics on cognition, we conducted a meta-analysis of randomized controlled trials (RCTs). METHODS: Instructions of the PRISMA 2020 statement were followed. Literature from the PubMed, Embase and Cochrane databases were systematically searched and manually screened for relevant published RCTs. We performed statistical analysis using RevMan, and assessed the risk of bias using the R software. RESULTS: A total of 12 studies comprising 852 patients with MCI or AD were identified. The results of meta-analysis showed that probiotics improved global cognitive function (SMD=0.67; 95% CI, 0.32, 1.02), recall/delayed memory (SMD=0.67; 95% CI: 0.32, 1.02), attention (SMD=0.31; 95% CI: 0.04, 0.58) and visuospatial/constructional (SMD=0.24; 95% CI: 0.06, 0.42) cognitive domain. CONCLUSION: This meta-analysis found that probiotic supplementation is associated with an improvement in cognitive performance among patients with AD and MCI. However, current evidence is limited, and more reliable large-scale RCTs with higher methodological quality are needed.

Asociación entre funcionalidad familiar y deterioro cognitivo leve en la familia con adulto mayor / Association between family functionality and mild cognitive impairment in the family with the elderly

Objetivo: Determinar la asociación entre funcionalidad familiar y deterioro cognitivo leve en la familia con adulto mayor. Metodología: Diseño transversal analítico en familias con pacientes geriátricos. Se consideró familia con paciente geriátrico cuando al menos uno de sus integrantes tenía más de 60años de edad. Los grupos de comparación fueron la familia con paciente geriátrico sin deterioro cognitivo y la familia con paciente geriátrico con deterioro cognitivo leve determinada con el instrumento MoCA. La funcionalidad familiar se evaluó con el instrumento APGAR familiar, el cual identifica tres categorías: funcionalidad familiar, disfuncionalidad familiar moderada y disfuncionalidad familiar severa. El análisis estadístico incluyó chi cuadrado y prueba de Mann Whitney. Resultados: En la familia con paciente geriátrico, en el grupo sin deterioro cognitivo la prevalencia de funcionalidad familiar es del 89,7% y en el grupo con deterioro cognitivo leve la prevalencia de funcionalidad familiar es del 59,3% (MW=4,87, p<0,000). Conclusión: Existe asociación entre funcionalidad familiar y deterioro cognitivo leve.(AU)

Aim: To determine the association between family functionality and mild cognitive impairment in the family with the elderly. Methodology: Analytical cross-sectional design in families with geriatric patients. A family with a geriatric patient was considered when at least one of its members was over 60years of age. The comparison groups were the family with a geriatric patient without cognitive impairment and the family with a geriatric patient with mild cognitive impairment determined with the MoCA instrument. Family functionality was evaluated with the family APGAR instrument, which identifies three categories: family functionality, moderate family dysfunction, and severe family dysfunction. Statistical analysis included Chi square and Mann-Whitney test. Results: In the family with a geriatric patient, in the group without cognitive impairment the prevalence of family functionality is 89.7% and in the group with mild cognitive impairment the prevalence of family functionality is 59.3% (MW=4.87, P<.000). Conclusion: There is an association between family functionality and mild cognitive impairment.(AU)

Is lifetime traumatic brain injury a risk factor for mild cognitive impairment in veterans compared to non-veterans?

Background: Traumatic brain injury (TBI) is prevalent in veterans and may occur at any stages of their life (before, during, or after military service). This is of particular concern, as previous evidence in the general population has identified TBI as a strong risk factor for mild cognitive impairment (MCI), a known precursor of dementia.Objectives: This study aimed to investigate whether exposure to at least one TBI across the lifetime was a risk factor for MCI in ageing UK veterans compared to non-veterans.Method: This cross-sectional study comprised of data from PROTECT, a cohort study comprising UK veterans and non-veterans aged ≥ 50 years at baseline. Veteran and TBI status were self-reported using the Military Service History Questionnaire (MSHQ) and the Brain Injury Screening Questionnaire (BISQ), respectively. MCI was the outcome of interest, and was defined as subjective cognitive impairment and objective cognitive impairment.Results: The sample population comprised of veterans (n = 701) and non-veterans (n = 12,389). TBI was a significant risk factor for MCI in the overall sample (OR = 1.21, 95% CI 1.11-1.31) compared to individuals without TBI. The prevalence of TBI was significantly higher in veterans compared to non-veterans (69.9% vs 59.5%, p < .001). There was no significant difference in the risk of MCI between veterans with TBI and non-veterans with TBI (OR = 1.19, 95% CI 0.98-1.45).Conclusion: TBI remains an important risk factor for MCI, irrespective of veteran status. The clinical implications indicate the need for early intervention for MCI prevention after TBI.

Data from the PROTECT study, a longitudinal study comprising over 25,000 middle-aged and ageing adults in the UK, were used in this first UK comparative study to explore the association between a lifetime history of traumatic brain injury (TBI) and mild cognitive impairment (MCI) in UK veterans and non-veterans.Lifetime TBI was more prevalent in veterans compared to non-veterans. TBI events in military veterans could be attributed to non-military events.Exposure to a history of TBI irrespective of veteran status increased the risk of MCI by 21% compared to adults with no history of TBI.The risk of MCI did not significantly differ between veterans and non-veterans with TBI.

[Association between family functionality and mild cognitive impairment in the family with the elderly]. / Asociación entre funcionalidad familiar y deterioro cognitivo leve en la familia con adulto mayor.

AIM: To determine the association between family functionality and mild cognitive impairment in the family with the elderly. METHODOLOGY: Analytical cross-sectional design in families with geriatric patients. A family with a geriatric patient was considered when at least one of its members was over 60years of age. The comparison groups were the family with a geriatric patient without cognitive impairment and the family with a geriatric patient with mild cognitive impairment determined with the MoCA instrument. Family functionality was evaluated with the family APGAR instrument, which identifies three categories: family functionality, moderate family dysfunction, and severe family dysfunction. Statistical analysis included Chi square and Mann-Whitney test. RESULTS: In the family with a geriatric patient, in the group without cognitive impairment the prevalence of family functionality is 89.7% and in the group with mild cognitive impairment the prevalence of family functionality is 59.3% (MW=4.87, P<.000). CONCLUSION: There is an association between family functionality and mild cognitive impairment.

Evaluación de validez convergente y discriminante de un protocolo de cribado online para detección de deterioro cognitivo leve en personas mayores en Chile

Introducción: La detección temprana del deterioro cognitivo en personas mayores permite disminuir la incertidumbre y mejorar las tareas de intervención. El objetivo de esta investigación fue determinar las características psicométricas de un protocolo de cribado online para detectar tempranamente deterioro leve en personas mayores. Método: el método usado fue de tipo mixta con preguntas de tipo cuantitativas y cualitativas. La muestra fue de 75 personas mayores del gran Concepción, región del Bio-Bio. El protocolo estaba compuesto por: Cuestionario sociodemográfico, Test del Reloj Versión Cacho, Moca, Escala Depresión Yesavage y Test Acentuación de Palabras. El procedimiento consistió en la aplicación del protocolo a través de un Tablet o Laptop, videollamadas. Resultados: Se encontró que el protocolo presenta validez discriminante y convergente. Conclusiones: se concluye que el protocolo de cribado online para detectar tempranamente deterioro leve en personas mayores es válido y fiable. Se discute el uso y la aplicación de un protocolo cribado usando la Teleneuropsicología (TeleNP), en personas mayores

ABTRACT Introduction: Early detection of cognitive impairment in the elderly allows us to reduce uncertainty and improve intervention tasks. The objective of this research was to determine the psychometric characteristics of an online screening protocol for early detection of mild impairment in the elderly. Method: the method used was of a mixed type with quantitative and qualitative questions. The sample consisted of 75 older people from the greater Concepción, Bio-Bio region. The protocol consisted of: Sociodemographic Questionnaire, Cacho Version Clock Test, Mocha, Yesavage Depression Scale and Word Stress Test. The procedure consisted of the application of the protocol through a Tablet or Laptop, video calls. Results: It was found that the protocol presents discriminant and convergent validity. Conclusions: it is concluded that the online screening protocol for early detection of mild deterioration in the elderly is valid and reliable. The use and application of a screening protocol using Teleneuropsychology (TeleNP) in older people is discussed.

Identification of Neuropsychiatric Symptoms in Preclinical and Prodromal Stages in Dementias: Development of a Screening Test for Mild Behavioral Impairment / Identificación de los Síntomas Neuropsiquiátricos en Fases Preclínicas y Prodrómicas en Demencias: Desarrollo de un Test de Cribado para el Deterioro Conductual Leve

Background: Neuropsychiatric symptoms (NPS) are a psychopathological dimension of neurodegenerative diseases, consisting of personality changes, behavioral disorders, and alterations in basic functions such as appetite or sleep, among others. The aim of this study was the construction and validation of a screening test to identify these NPS associated with neurodegenerative pathologies in preclinical and prodromal stages, based on the ISTAART criteria for Mild Behavioral Impairment (MBI). Method: The sample consisted of 206 subjects over 55 years old (117 cognitively healthy, 89 with Mild Cognitive Impairment). 69% were women, the mean age was 77 years (SD = 10.58). Results: The new scale consists of 19 items and exhibited a one-dimensional structure. Confidence was excellent (α = .94 and Ω = .97) and there was evidence of convergent validity with the MBI-C test (r = .88) and the NPI-Q (r = .82). In addition, the scale demonstrated good sensitivity (.88) and specificity (.80). Conclusions: The scale allows evaluation of NPS in DCoL. It exhibits good psychometric properties and makes a useful tool in early diagnosis of neurodegenerative pathologies.(AU)

Antecedentes: Los síntomas neuropsiquiátricos (SNP) constituyen una dimensión psicopatológica de las enfermedades neurodegenerativas conformada por cambios en la personalidad, trastornos conductuales o alteraciones en funciones básicas como, entre otras, el apetito o el sueño. El objetivo de este estudio es la construcción y validación de un test de cribado para la identificación de estos SNP asociados a patologías neurodegenerativas en etapas preclínicas y prodrómicas y basado en los criterios ISTAART para el Deterioro Conductual Leve (DCoL). Método: Se empleó una muestra de 206 sujetos mayores de 55 años (117 cognitivamente sanos y 89 con Deterioro Cognitivo Leve) siendo el 69% mujeres, con una media de edad de 77 años (DT = 10,58). Resultados: La nueva escala desarrollada consta de 19 items y muestra una estructura unidimensional. La fiabilidad fue excelente (α = .94 y Ω = .97) y se observaron evidencias de validez convergente con el test MBI-C con una correlación de .88 y la NPI-Q con .82. Además, muestra una buena sensibilidad de .88 y especificidad de .80. Conclusiones: La escala desarrollada permite evaluar los SNP en el DCoL mostrando buenas propiedades psicométricas y constituyendo una herramienta muy útil en el diagnóstico precoz de las patologías neurodegenerativas.(AU)

Asociación entre la salud oral y el deterioro cognitivo leve en adultos mayores / Association between Oral Health and Mild Cognitive Impairment in Older Adults

Introducción: En la medida que se incrementa la población de adultos mayores, aumenta la prevalencia, aumenta la prevalencia del deterioro cognitivo. Recientemente, se ha introducido la mala salud oral entre los factores de riesgo potenciales. Objetivo: Determinar la asociación entre la salud oral y el deterioro cognitivo leve en adultos mayores de una comunidad de la provincia de Santiago de Cuba. Métodos: Se realizó un estudio observacional, analítico y retrospectivo, de tipo casos y controles en el período comprendido entre enero y julio del año 2023. La población de estudio estuvo constituida por 257 adultos mayores que vivían en esta comunidad, de los cuales se escogieron 40 casos con diagnóstico de deterioro cognitivo leve, según los criterios de Petersen. Se seleccionaron tres controles por cada caso, 120 adultos mayores con aproximadamente las mismas características que el caso. Se precisó la fuerza de asociación de cada factor de riesgo. Resultados: Se halló una asociación significativa entre padecer deterioro cognitivo leve y presentar un número de 1 a 9 dientes. El dolor oral se presentó con mayor frecuencia en el 72,5 por ciento de los casos. No recordar la última visita al estomatólogo fue causa de deterioro cognitivo leve en el 42,5 por ciento. Cepillarse irregularmente se asoció 4,1 veces más con el riesgo de desarrollar esta afección. Conclusiones : Existe una asociación entre la salud oral y el deterioro cognitivo leve en los adultos mayores. Tener menos dientes y referir dolor oral fueron factores de riesgo importantes para presentar deterioro cognitivo. La visita al estomatólogo y el cepillado de dientes irregular influyeron negativamente en la enfermedad. Sin embargo, el uso de prótesis dentales fue un factor protector para el deterioro cognitivo leve(AU)

Introduction: Along with the increase in the population of older adults, the prevalence of cognitive impairment is increasing. Recently, poor oral health has been introduced among potential risk factors. Objective: To determine the association between oral health and mild cognitive impairment in older adults in a community in the province of Santiago de Cuba. Methods: An observational, analytical and retrospective case-control study was carried out from January to July 2023. The study population consisted of 257 older adults living in this community, from which 40 cases were selected with a diagnosis of mild cognitive impairment, according to Petersen's criteria. Three controls were selected for each case, 120 older adults with approximately the same characteristics as the case. The strength of association of each risk factor was determined. Results: A significant association was found between having mild cognitive impairment and having 1 to 9 teeth. Oral pain was more frequent in 72.5 percent of the cases. Not remembering the last visit to the dentist was a cause of mild cognitive impairment in 42.5 percent. Irregular brushing was 4.1 times more associated with the risk of developing this condition. Conclusions: There is an association between oral health and mild cognitive impairment in older adults. Having fewer teeth and reporting oral pain were important risk factors for cognitive impairment. Visiting the dentist and irregular tooth brushing had a negative influence on the disease. However, the use of dental prosthetics was a protective factor for mild cognitive impairment(AU)

Subjective Cognitive and Communicative Complaints and Health-Related Quality of Life in Parkinson's Disease with and without Mild Cognitive Impairment.

INTRODUCTION: Mild Cognitive Impairment (MCI) is common in Parkinson's Disease (PD). Few studies have compared the Health-Related Quality of Life (HRQoL) in patients with and without MCI due to PD (PD-MCI), and its correlation to patients' subjective cognitive and communicative difficulties has not been explored. OBJECTIVE: We aimed to compare HRQoL in PD-MCI and PD without MCI (PD-nMCI), and explore its possible relationship to subjective cognitive and communicative complaints. METHODS: We included 29 PD-nMCI and 11 PD-MCI patients. The HRQoL was assessed with the Parkinson's Disease Questionnaire-39 (PDQ-39): its Cognition dimension was used as a measure of subjective cognitive complaints, its Communication dimension for subjective communicative complaints, and the summary index (PDQ-39 SI) as an indicator of HRQoL. Non-parametric partial correlations between the Cognition and Communication dimensions, and the adjusted PDQ-39 SI were conducted. RESULTS: PD-MCI patients had greater subjective cognitive and communicative complaints and worse HRQoL than PD-nMCI patients. In the PD-MCI group, both subjective cognitive and communicative complaints exhibited significant direct correlations with the adjusted HRQoL scores. CONCLUSIONS: HRQoL seems to be affected in PD-MCI, and it might be influenced by greater subjective cognitive and communicative complaints. Including patient-reported outcome measures of HRQoL, and providing cognitive and speech rehabilitation, as well as psychotherapeutic strategies to face these deficits can enhance the patient-centred approach in PD.

Is it possible to prevent the progression of mild cognitive impairment through non-pharmacological treatments?

INTRODUCTION: Mild cognitive impairment produces slight cognitive and motor disturbances without affecting daily life during aging, however, if this symptomatology is not controlled, the speed of deterioration can increase, and even some cases of dementia can appear in the elderly population. OBJECTIVE: To describe non-pharmacological therapies that seek to prevent, control and reduce the symptoms of mild cognitive impairment. METHODS: An initial search was carried out in the databases of PubMed, Lilacs, EBSCO, ScienceDirect, Taylor & Francis and ProQuest. The results found were filtered through the PRISMA system and biases evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Four categories of non-pharmacological therapies were created, using 50 articles found in the search, which contribute to controlling and improving cognitive and motor areas, in order to reduce the symptoms presented by mild cognitive impairment. The treatments have different methods, instruments and objectives, so that no meta-analysis of the studies could be performed. In addition, limitations related to the sample, the effectiveness of the results and the methodological quality were found. CONCLUSIONS: It was found that non-pharmacological therapies prevent, improve and control the symptoms caused by mild cognitive impairment, however, it is necessary to carry out more studies with better methodologies to corroborate these results.

Predictores de riesgo de deterioro cognitivo leve en una población de hipertensos / Predictors of Mild Cognitive Impairment in a Hypertensive Population

RESUMEN Introducción. El estatus cognitivo es considerado un biomarcador del daño vascular encefálico en la hipertensión arterial (HTA). Es fundamental en pacientes con HTA la pesquisa del deterioro cognitivo leve (DCL). Objetivos . Valorar la presencia de factores predictores de DCL en pacientes hipertensos. Material y métodos . Estudio observacional, transversal, en el periodo 2015-2023. Se incluyeron pacientes mayores de 18 años, asistidos en policlínica que hubieran realizado la Evaluación Cognitiva de Montreal (MoCA). Se consideró valor de MoCA alterado uno < 24. Se excluyeron pacientes con dificultades motoras, sensoriales, enfermedad psiquiátrica, analfabetismo. Las variables cualitativas se presentan como frecuencias absolutas y relativas, y para el estudio de asociación se utilizó test de Chi cuadrado. Las variables cuantitativas se presentan como media y desviación estándar, y el estudio de diferencias se realizó con test T de Student para muestras independientes. En el análisis de regresión logística múltiple se colocaron aquellas variables significativas en el análisis univariado por el método Forward. Nivel de significación alfa = 0,05. Resultados . 129 pacientes, mujeres: hombres 2:1; edad promedio 60 años. El 79,1 % tenía HTA grado 3, 30,4 % presentaban más de 20 años de evolución de HTA. El 52,7% tenía escolarización primaria. Un 89,4 % presentaba sobrepeso-obesidad, el 36,4 % tabaquismo, 29,7 % dislipidemia mixta. Un 65,1% presentó un valor de MoCA ≥ 24 y el 34,9 % un valor < 24. En el modelo predictor logístico, las variables evolución en años de HTA, dislipidemia mixta, y enfermedad cerebrovascular fueron predictoras de riesgo de MoCA alterado. El nivel educativo terciario fue factor protector. Conclusión . La identificación de factores predictores de daño cognitivo es prioritaria para una acción preventiva. En este estudio las variables tiempo de evolución de la HTA, dislipidemia mixta, enfermedad cerebrovascular y nivel educativo permitieron predecir mayor riesgo de DCL.

ABSTRACT Background . Cognitive status is considered a biomarker of vascular brain damage caused by hypertension (HTN). Screening for mild cognitive impairment (MCI) is essential in patients with HTN. Objectives . The aim of this study was to evaluate the presence of predictors of MCI in hypertensive patients. Methods . We conducted an observational and cross-sectional study between 2015 and 2023. All the patients > 18 years treated in a clinic and who were evaluated with the Montreal Cognitive Assessment (MoCA) were included. A score < 24 in the MoCA test was considered abnormal. Patients with motor or sensory impairment, psychiatric disorders, or illiteracy were excluded. Qualitative variables are presented as absolute frequencies and percentages, and the chi-square test was used to analyze their association. Quantitative variables are expressed as mean ± standard deviation and were compared with the independent samples t-test. All the variables with statistical significance in the univariate analysis through forward selection were included in the multiple logistic regression analysis. A p value < 0.05 was considered statistically significant. Results . A total of 129 patients were included (women-to-men ratio 2:1; mean age 60 years); 79.1% had stage 3 HTN, time from HTN diagnosis was > 20 years in 30.4%, 52.7% had complete primary education, 89.4% had overweight/obesity, 36.4% were smokers and 29.7% had mixed dyslipidemia. A score ≥ 24 in the MoCA was present in 65.1% and 34.9% had a score < 24. The logistic predictor model identified time from HTN diagnosis, mixed dyslipidemia and cerebrovascular disease as predictors of abnormal MoCA. A tertiary educational level had a protective effect. Conclusion . Identifying predictors of cognitive impairment is a priority to take preventive actions. In this study, time from HTN diagnosis, mixed dyslipidemia, cerebrovascular disease and educational level were associated with cognitive impairment.

Alertamientos y movimientos periódicos de las piernas durante las etapas de sueño y deterioro cognitivo leve en adultos mayores. Estudio preliminar / Arousals and periodic leg movements during sleep stages and mild cognitive impairment in older adults: a preliminary study

RESUMEN La fragmentación del sueño puede asociarse con distintas enfermedades, entre ellas, la demencia. En este sentido, la fragmentación de sueño, indicada por el índice de alertamientos y/o movimientos periódicos de las piernas (MPP), podría ser un marcador temprano de deterioro cognitivo leve (DCL), un síndrome precursor de la demencia. El objetivo del presente estudio fue medir el índice de prevalencia de los alertamientos y de los MPP durante el sueño en un grupo control y un grupo con DCL, así como determinar si hay diferencia entre los grupos en ambos índices y establecer si existe una correlación entre los dos fenómenos. En 9 participantes (3 mujeres controles y 3 mujeres con DCL; y 3 hombres con DCL) (edad: 69.1 ± 5; años de educación: 8 ± 2) se registró una noche de polisomnografía. Se obtuvieron los índices por hora de alertamientos y para cada etapa de sueño, así como los MPP globales y por hora; además se realizaron análisis entre y dentro de cada grupo. Se encontró una correlación positiva y un mayor número de MPP que de alertamientos durante toda la noche en los participantes con DCL. Conocer la prevalencia y asociación de ambos fenómenos contribuye en la formulación de una evaluación más cuidadosa y profunda de los adultos mayores en riesgo de desarrollar DCL y/o demencia.

ABSTRACT Sleep fragmentation may be associated with several diseases, including dementia. In this sense, sleep fragmentation, indicated by the rates of arousals and/or periodic leg movements (PLM), could be an early marker of Mild Cognitive Impairment (MCI), a syndromic stage prior to dementia. Therefore, the objective of this study was to compare the index of PLM with that of arousals and correlate both indexes in people with MCI and without MCI during all sleep stages. In 9 participants (3 control women and 3 women with MCI; and 3 men with MCI) (ages: 69.1 ± 5; years of education: 8 ± 2), one night of polysomnography was performed. Hourly rates of arousals and PLM were scored from each sleep stage. Analyses were performed within and between PLM and arousals for each group. Significant differences and a positive correlation were found between the arousal and the PLM rates for the group with MCI during the whole night. Knowledge of the prevalence and the association of both phenomena may contribute to a more careful and thorough evaluation of older adults at risk of developing MCI and/or dementia.

Valor pronóstico de los biomarcadores licuorales en el deterioro cognitivo leve debido a enfermedad de Alzheimer / Prognostic value of cerebrospinal fluid biomarkers in mild cognitive impairment due to Alzheimer disease

Realizamos un análisis retrospectivo de los pacientes evaluados en nuestra unidad de memoria en los que se realizó determinación de biomarcadores licuorales de enfermedad de Alzheimer (EA). Se seleccionaron aquellos casos con diagnóstico de deterioro cognitivo leve debido a EA según criterios clínicos (criterios NIA-AA), déficit neuropsicológico comprobado, una puntuación igual a 3 en la escala GDS y un perfil alterado de biomarcadores en líquido cefalorraquídeo. De los 588 casos revisados, 110 cumplieron los criterios de inclusión. Durante el seguimiento, 50 de estos 110 casos (45,45%) progresaron a demencia por EA. Se observaron diferencias significativas en los niveles basales de tau total y tau fosforilada entre los casos que evolucionaron a demencia y los que permanecieron estables como deterioro cognitivo leve, siendo los niveles más altos en el grupo que progresó a demencia. Después del ajuste por edad, sexo, antecedentes de hipertensión, diabetes y nivel educativo, un aumento del 10% en los valores de proteína tau total se asoció con un aumento del 7,60% en el riesgo de progresión a demencia (HR = 2,22, IC 95% [1,28, 3,84], p = 0,004). En pacientes con deterioro cognitivo leve debido a EA un perfil alterado de biomarcadores licuorales, concentraciones progresivamente mayores de tau-t y tau-p se asocian a un mayor riesgo de conversión a demencia.(AU)

We performed a retrospective analysis of the patients assessed at our memory unit for whom Alzheimer disease (AD) cerebrospinal fluid biomarker results were available. We selected patients diagnosed with mild cognitive impairment due to AD (National Institute on Aging-Alzheimer's Association clinical criteria), confirmed neuropsychological deficit, a Global Deterioration Scale score of 3, and an abnormal profile of cerebrospinal fluid biomarkers. Of the 588 cases reviewed, 110 met the inclusion criteria. During follow-up, 50 cases (45.45%) progressed to dementia due to AD. Baseline levels of total and phosphorylated tau were higher in the group of patients that progressed to dementia than in those remaining with mild cognitive impairment. After adjusting for age, sex, history of hypertension, diabetes, and educational level, a 10% increase in total tau protein values was associated with a 7.60% increase in the risk of progression to dementia (hazard ratio: 2.22; 95% confidence interval, 1.28-3.84]; P = .004). Among patients with mild cognitive impairment due to AD and abnormal cerebrospinal fluid biomarker profiles, progressively higher concentrations of total or phosphorylated tau were associated with increased risk of progression to dementia.(AU)

Prognostic value of cerebrospinal fluid biomarkers in mild cognitive impairment due to Alzheimer disease.

We performed a retrospective analysis of the patients assessed at our memory unit for whom Alzheimer disease (AD) cerebrospinal fluid biomarker results were available. We selected patients diagnosed with mild cognitive impairment due to AD (National Institute on Aging-Alzheimer's Association clinical criteria), confirmed neuropsychological deficit, a Global Deterioration Scale score of 3, and an abnormal profile of cerebrospinal fluid biomarkers. Of the 588 cases reviewed, 110 met the inclusion criteria. During follow-up, 50 cases (45.45%) progressed to dementia due to AD. Baseline levels of total and phosphorylated tau were higher in the group of patients that progressed to dementia than in those remaining with mild cognitive impairment. After adjusting for age, sex, history of hypertension, diabetes, and educational level, a 10% increase in total tau protein values was associated with a 7.60% increase in the risk of progression to dementia (hazard ratio: 2.22; 95% confidence interval, 1.28-3.84]; P = .004). Among patients with mild cognitive impairment due to AD and abnormal cerebrospinal fluid biomarker profiles, progressively higher concentrations of total or phosphorylated tau were associated with increased risk of progression to dementia.

Association between vitamin B12 levels and cognitive impairment in older adults.

INTRODUCTION: Whether vitamin B12 deficiency is associated with cognitive impairment remains controversial. OBJECTIVE: To determine the association between vitamin B12 serum levels and cognitive performance. METHODS: Two-hundred and forty-one adults aged ≥ 60 years who had serum vitamin B12 serum levels measurement were included. Physical and cognitive evaluation was carried out, and three groups were formed: normal cognition (NC), mild cognitive impairment (MCI) and dementia. Vitamin B12 levels were classified as sufficiency (> 400 pg/mL), subclinical deficiency (201-400 pg/mL), and absolute deficiency (≤ 200 pg/mL). Multivariate linear regression analysis was used to evaluate the association between cognitive function and vitamin B12 levels after controlling for confounding variables. RESULTS: Mean age was 81.4 ± 8.0 years; 68% were females; 17.8 % and 39.8% had absolute and subclinical vitamin B12 deficiency, respectively; 80 individuals (33%) met the criteria for MCI, and 70 (29%), for dementia. Those with MCI and dementia had lower vitamin B12 levels in comparison with those with NC after adjusting for age, gender and educational level (p = 0.019). CONCLUSIONS: A statistically significant association was observed between global cognitive performance and levels of vitamin B12.

INTRODUCCIÓN: Aún es controversial si la deficiencia de vitamina B12 se asocia a alteraciones cognitivas. OBJETIVO: Conocer la asociación entre los niveles séricos de vitamina B12 y el desempeño cognitivo. MÉTODOS: Se incluyeron 241 personas ≥ 60 años con medición de niveles séricos de vitamina B12. Se realizó evaluación física y cognitiva y se formaron tres grupos: cognición normal (CN), deterioro cognitivo leve (DCL) y demencia. Los niveles de vitamina B12 se clasificaron en suficiencia (> 400 pg/mL), deficiencia subclínica (201-400 pg/mL) y deficiencia absoluta (≤ 200 pg/mL). Se realizó análisis de regresión lineal multivariado para evaluar la asociación entre función cognitiva y niveles de vitamina B12 después de controlar las variables confusoras. RESULTADOS: La media de edad fue 81.4 ± 8.0 años; 68 % fue del sexo femenino; 17.8 y 39.8 % presentaron deficiencia absoluta y subclínica de vitamina B12; 80 individuos (33 %) cumplieron los criterios de DCL y 70 (29 %), de demencia. Después de ajustar por edad, sexo y escolaridad, los sujetos con DCL y demencia tuvieron niveles más bajos de vitamina B12 comparados con aquellos con CN (p = 0.019). CONCLUSIONES: Se observó asociación estadísticamente significativa entre el desempeño cognitivo global y los niveles bajos de vitamina B12.

Asociación entre los niveles de vitamina B12 y el deterioro cognitivo en personas mayores / Association between vitamin B12 levels and cognitive impairment in older adults

Resumen Introducción: Aún es controversial si la deficiencia de vitamina B12 se asocia a alteraciones cognitivas. Objetivo: Conocer la asociación entre los niveles séricos de vitamina B12 y el desempeño cognitivo. Métodos: Se incluyeron 241 personas ≥ 60 años con medición de niveles séricos de vitamina B12. Se realizó evaluación física y cognitiva y se formaron tres grupos: cognición normal (CN), deterioro cognitivo leve (DCL) y demencia. Los niveles de vitamina B12 se clasificaron en suficiencia (> 400 pg/mL), deficiencia subclínica (201-400 pg/mL) y deficiencia absoluta (≤ 200 pg/mL). Se realizó análisis de regresión lineal multivariado para evaluar la asociación entre función cognitiva y niveles de vitamina B12 después de controlar las variables confusoras. Resultados: La media de edad fue 81.4 ± 8.0 años; 68 % fue del sexo femenino; 17.8 y 39.8 % presentaron deficiencia absoluta y subclínica de vitamina B12; 80 individuos (33 %) cumplieron los criterios de DCL y 70 (29 %), de demencia. Después de ajustar por edad, sexo y escolaridad, los sujetos con DCL y demencia tuvieron niveles más bajos de vitamina B12 comparados con aquellos con CN (p = 0.019). Conclusiones: Se observó asociación estadísticamente significativa entre el desempeño cognitivo global y los niveles bajos de vitamina B12.

Abstract Introduction: Whether vitamin B12 deficiency is associated with cognitive impairment remains controversial. Objective: To determine the association between vitamin B12 serum levels and cognitive performance. Methods: Two-hundred and forty-one adults aged ≥ 60 years who had serum vitamin B12 serum levels measurement were included. Physical and cognitive evaluation was carried out, and three groups were formed: normal cognition (NC), mild cognitive impairment (MCI) and dementia. Vitamin B12 levels were classified as sufficiency (> 400 pg/mL), subclinical deficiency (201-400 pg/mL), and absolute deficiency (≤ 200 pg/mL). Multivariate linear regression analysis was used to evaluate the association between cognitive function and vitamin B12 levels after controlling for confounding variables. Results: Mean age was 81.4 ± 8.0 years; 68% were females; 17.8 % and 39.8% had absolute and subclinical vitamin B12 deficiency, respectively; 80 individuals (33%) met the criteria for MCI, and 70 (29%), for dementia. Those with MCI and dementia had lower vitamin B12 levels in comparison with those with NC after adjusting for age, gender and educational level (p = 0.019). Conclusions: A statistically significant association was observed between global cognitive performance and levels of vitamin B12.

Adaptación de personas adultas mayores frente al deterioro cognitivo leve: teoría de rango medio / Adaptation of older adults facing mild cognitive impairment: middle range theory

Objetivo: Describir una propuesta de teoría de rango medio basada en el Modelo de Adaptación de Roy (MAR) que incorpora estrategias de compensación de memoria para la adaptación de personas adultas mayores con deterioro cognitivo leve (DCL). Metodología: Se utilizó la formalización conceptual-teórica-empírica para analizar la congruencia entre los conceptos del modelo parental (MAR) y la teoría propuesta. Resultados: Los conceptos clave retomados son: (a) nivel de adaptación compensatorio (representado por el DCL), (b) estímulos contextuales (edad, sexo, escolaridad, conciencia de problemas de memoria, depresión y ansiedad), (c) estímulo focal (la intervención), (d) subsistema cognator (el uso de compensadores de memoria) y (e) la adaptación general (actividades instrumentales de la vida diaria). Conclusión: La propuesta teórica es congruente con el MAR y capaz de orientar los conceptos de una intervención de enfermería que pretende promover la adaptación ante el DCL en adultos mayores.(AU)

Objective: To describe a middle-range theory proposal based on Roy's Adaptation Model (RAM) that incorporates memory compensation strategies for the adaptation of older adults with mild cognitive impairment (MCI). Methods: Formalization of conceptual-theoretical-empirical structure was used to analyze the congruence between the concepts of the parental model (RAM) and the proposed theory. Results: The key concepts used are: (a) compensatory adaptation level (represented by MCI), (b) contextual stimuli (age, sex, schooling, awareness of memory problems, depression and anxiety), (c) focal stimulus (the intervention), (d) cognator subsystem, represented by the use of memory compensators; and (e) general adaptation (instrumental activities of daily living). Conclusion: The theoretical proposal shows congruence with the RAM and capability to guide the concepts of a nursing intervention that pretends to promote adaptation in older adults facing cognitive decline.(AU)

Intervenciones cognitivas a través de realidad virtual en personas con Deterioro Cognitivo Leve: Una Revisión Sistemática

Introducción: La posibilidad de reversión del Deterioro Cognitivo Leve (DCL) ha generado diversas investigaciones en búsqueda de tratamiento, entre ellas la estimulación cognitiva a través de realidad virtual (RV). No obstante su uso, no existe aún evidencia acerca de las modalidades y efectos en personas con DCL. Objetivo: Sistematizar las características de los estudios que han utilizado intervenciones cognitivas con RV en personas con DCL, describir sus efectos y establecer recomendaciones para futuras investigaciones en base a las limitaciones reportadas. Métodos: revisión sistemática de estudios publicados entre 2010 y 2020, en las bases de datos Web of Science, Scopus y Pubmed. Resultados: Se identificaron 14 estudios con programas que emplearon mayoritariamente RV de tipo inmersiva, con el "supermercado" como escenario virtual más frecuente. En siete trabajos se intervino una función cognitiva, siendo la memoria y las funciones ejecutivas las más intervenidas. Los instrumentos de evaluación se concentraron en medidas cognitivas, con escasa evaluación de variables neuropsiquiátricas y de calidad de vida. Trece estudios informaron mejoras a nivel cognitivo general o por dominio específico. Conclusiones: La utilización de RV, inmersiva y no inmersiva, ha tenido resultados positivos en el rendimiento cognitivo general o específico por dominio, de personas con DCL, sin embargo, debido a la incipiente y limitada evidencia de su uso en personas con esta patología, no es posible determinar la sostenibilidad de estos resultados y la generalización de estas intervenciones hacia las actividades de la vida diaria. Se recomienda realizar intervenciones con entornos reales y seguimiento post-intervención.

Introduction: The possibility of Mild Cognitive Impairment (MCI) reversal has generated numerous studies in search of treatment, including cognitive stimulation through virtual reality (VR). Despite its use, there is still no evidence about the modalities and effects in people with MCI. Aim: To systematize the characteristics of the studies that have used cognitive interventions with VR cognitive in people with MCI, describe their effects and to establish recommendations for future research based on the limitations reported. Methods: systematic review of studies published between 2010 and 2020, in the Web of Science, Scopus and Pubmed databases. Results: 14 studies were identified with programs that mostly used immersive VR, with the "supermarket" as the most frequent virtual scenario. In seven studies only one cognitive function was involved, with memory and executive functions being the most intervened. The assessment instruments focused on cognitive measures, with little assessment of neuropsychiatric and quality of life variables. Thirteen studies reported improvements on the general cognitive level or by specific domain. Conclusions: The use of immersive and non-immersive VR has had positive results in the general or domain-specific cognitive performance of people with MCI, however, due to the incipient and limited evidence of its use in people with this pathology, it is not possible to determine the sustainability of these results and the generalization of these interventions regarding daily living activities. Interventions with real environments and post-intervention follow-up are recommended.

Depression and Suicide Risk in Mild Cognitive Impairment: The Role of Alzheimer’s Disease Biomarkers / Depresión y Riesgo de Suicidio en el Deterioro Cognitivo Leve: el Rol de los Biomarcadores de la Enfermedad de Alzheimer

Background: Patients with depression and mild cognitive impairment (MCI) are at greater risk of developing dementia. Depression involves a higher risk of suicidal ideation (SI) and suicide attempts (SA). Biomarkers of Alzheimer’s Disease (AD) could help to clarify the role of depression and SI in AD. Method: Fifty-nine participants aged > 50 with criteria of MCI positive (MCI-AD) (n=22) and negative (MCI-Non AD) (n=24) AD and healthy controls (HC) (n=13) were evaluated. We used the Geriatric Depression Scale (GDS-30) and the GDS-SI factor to measure depression and indirect risk for suicide, respectively. Additionally, AD biomarkers such as amyloid-ß (Aß), hyperphosphorilated tau (P-tau), and total tau (T-tau) in cerebrospinal fluid (CSF) were analyzed. Results: No significant differences between the groups were found in depression. However, in the MCI-AD group, lower P-tau and T-tau levels were related to higher GDS-SI scores, suggesting that MCI-AD patients with lower AD pathology are at a higher risk of suicide. Conclusions: The result highlights the importance of considering SI in the initial phases of AD, and the potential role of AD biomarkers in early detection of symptoms.(AU)

Antecedentes: Los pacientes con depresión y deterioro cognitivo leve (DCL) tienen un alto riesgo de desarrollar demencia. La depresión implica un alto riesgo de ideación suicida (IS) e intentos de suicidio (AS). Los biomarcadores de la enfermedad de Alzheimer (EA) pueden clarificar el papel de la depresión e IS en la EA. Método: Cincuenta y nueve participantes >50 años con criterios de DCL-EA positivo (DCL-EA; 22) y negativo (DCL-NoEA; 24) y 13 controles sanos. La depresión fue evaluada con la Escala Geriátrica de Depresión (GDS-30) y la IS con el factor GDS-IS. Además, se midieron los siguientes biomarcadores en el líquido cefalorraquídeo: ß-amiloide (ß-A), tau hiperfosforilada (H-tau) y total (T-tau). Resultados: No se encontraron diferencias significativas entre los tres grupos de participantes en depresión o en IS. Sin embargo, en el grupo DCL-EA, niveles más bajos de H-tau y T-tau, indicadores de menor patología EA, se relacionaron significativamente con mayor riesgo de suicidio indirecto. Conclusiones: Este resultado subraya la importancia de considerar la IS en fases iniciales de EA, y el potencial papel de los biomarcadores de EA para detectar sus síntomas.(AU)

Preliminary analysis of a shortened picture version of the Free and Cued Selective Reminding Test.

INTRODUCTION: A picture version of the Free and Cued Selective Reminding Test (FCSRT) would assist in the assessment of memory function in patients with low levels of schooling. A shortened version would improve the test's applicability. OBJECTIVES: To analyse the diagnostic usefulness of a shortened picture version of the FCSRT for distinguishing patients with amnestic mild cognitive impairment (aMCI) from controls, without excluding participants with a low level of schooling. METHODS: Phase I study of a diagnostic evaluation (convenience sampling; pre-test prevalence 50%). A blinded researcher independently administered the FCSRT to 30 patients with aMCI and 30 controls matched for age, sex, level of schooling and literacy, using images and omitting the usual 30-minutes delayed recall item. Three variables were recorded: free recall, total recall, and cue efficiency. Diagnostic accuracy was calculated using receiver operating characteristic curves and the area under the curve. The Youden index was used to identify optimal cut-off points. RESULTS: Of all participants, 41.7% had not completed primary education. There were no differences between groups as regards sociodemographic variables. Area under the curve was excellent for free recall (0.99), total recall (0.95), and cue efficiency (0.93). The optimal cut-off points were 21/22, 43/44, and < 0.77, respectively. CONCLUSIONS: This preliminary analysis shows that a shortened picture version of the FCSRT may be useful and applicable for the diagnosis of aMCI without excluding individuals with a low level of schooling.