Alzheimer’s disease (AD) is a common and serious form of elderly dementia, but early detection and treatment of mild cognitive impairment can help slow down the progression of dementia. Recent studies have shown that there is a relationship between overall cognitive function and motor function and gait abnormalities. We recruited 302 cases from the Rehabilitation Hospital Affiliated to National Rehabilitation Aids Research Center and included 193 of them according to the screening criteria, including 137 patients with MCI and 56 healthy controls (HC). The gait parameters of the participants were collected during performing single-task (free walking) and dual-task (counting backwards from 100) using a wearable device. By taking gait parameters such as gait cycle, kinematics parameters, time-space parameters as the focus of the study, using recursive feature elimination (RFE) to select important features, and taking the subject’s MoCA score as the response variable, a machine learning model based on quantitative evaluation of cognitive level of gait features was established. The results showed that temporal and spatial parameters of toe-off and heel strike had important clinical significance as markers to evaluate cognitive level, indicating important clinical application value in preventing or delaying the occurrence of AD in the future.
ObjectiveTo analyze the risk factors of cognitive dysfunction in patients with epilepsy, and provide evidence for clinical prevention and treatment.MethodsDuring the period from January 1, 2018 to January 31, 2019, 101 patients with epilepsy who were admitted to the epilepsy specialist clinic of the General Hospital of Ningxia Medical University were included in this study. The cognitive function of the patients was evaluated by the Mini-mental State Examination (MMSE) scale and patients were divided into cognitive impairment group and normal cognitive function group according to the MMSE. Single factor and logistic regression analysis were used to find the differences of influencing factors between the two groups.Results① There were 27 cases of cognitive dysfunction in 101 patients with epilepsy, the incidence of cognitive impairment was 26.7%; ② Univariate analysis showed that the course of disease, frequency of seizures, seizure forms, anti-epileptic drugs (AEDs) and abnormal rate of electroencephalogram (EEG) existed significant differences between the two groups (P<0.05). ③ Logistic regression showed that course of disease, frequency of seizures and AEDs multidrug therapy were independent risk factors for cognitive dysfunction in patients with epilepsy (P<0.05).ConclusionCourse of disease, frequency of seizures and AEDs multidrug therapy are independent risk factors for cognitive dysfunction in patients with epilepsy.
ObjectiveTo explore the quality of life (QOL) of rural cognitive function impaired elderly in Guangyuan city and analysis the influencing factors, in order to provide evidence for improving the QOL of rural cognitive function impaired elderly. MethodsBy stratified cluster sampling method, Mini-Mental State Examination (MMSE) was adopted in the cognitive function impaired screening in Guangyuan rural area of Sichuan province in 2012, then we used SF-12 questionnaire to evaluate the QOL of those rural elderly (more than 60 years old) whose cognitive function was impaired. ResultsA total of 270 rural cognitive function impaired elderly were selected from 735 old people. The results of QOL assessment showed that:the mean of physical component summary (PCS) was 37.93±11.55, and the mean of mental component summary (MCS) was 44.07±13.14. Gender, age, education levels, economic situation of the selfassessment, chronic disease, being engaging in physical labour and daily life care were correlated with the score of QOL. ConclusionIn order to improve their QOL, we should help the elderly with cognitive function impaired and focus on prevention and individual treatment; their special difficulties should be fully considered when making the policy of health care and social security.
ObjectiveTo investigate the effects of hippocampal long-term potentiation (LTP) on cognitive dysfunction in immature epileptic rats. MethodsImmature epileptic rats were established by intraperitoneal injection of lithium chloride-pilocarpine (li-pilo). Racine classification standard modified by Becker was used to evaluate behavior of epileptic seizure, and the survival rats within RacineⅣmagnitude were selected in the experiment. The function of learning and memory of epileptic rats when they were adult was assessed using Morris water maze experiment, and their independent exploratory behavior was evaluated by the open-field test. Field potential was recorded by electrophysiological technology to detecte whether hippocampal LTP was essential of cognitive dysfunction. ResultsThe function of learning and memory was significantly impaired when compared with controls(n=8, t=10.86, P < 0.05;n=8, t=9.98, P < 0.05). In addition, independent exploratory behavior was significantly reduced when compared with controls(n=8, t=12.89, P < 0.05). Besides, CA1 hippocampal LTP induced by high-frequency stimulation presented the significant inhibition in epileptic rats with cognitive dysfunction when compared with controls(Slope:n=8, t=13.32, P < 0.05;Amplitude:n=8, t=20.02, P < 0.05). ConclusionInhibition of CA1 hippocampal LTP may be implicated in cognitive dysfunction of epileptic rats.
Objective To explore the correlation between the levels of serum nuclear factor-erythroid 2-related factor 2 (Nrf2) as well as heme oxygenase-1 (HO-1) and cognitive dysfunction by determining the levels of Nrf2 and HO-1 in patients with obstructive sleep apnea (OSA) to different degrees and combining Montreal cognitive assessment (MoCA). Methods Serum levels of Nrf2 and HO-1 were determined in 32 patients with mild-moderate OSA, 23 patients with severe OSA and 20 healthy controls. The differences of Nrf2 and HO-1 levels among groups were compared. All subjects were evaluated by MoCA score. According to MoCA score, OSA patients were divided into two groups: OSA with mild cognitive impairment (MCI) group and OSA with normal cognition group. Serum Nrf2 and HO-1 levels were compared between the two groups, and the differences in the OSA patients with or without cognitive impairment were understood. Spearman correlation coefficient was used to explore the correlation between serum Nrf2 and HO-1 levels and cognitive function of OSA patients. The diagnostic value of serum Nrf2 and HO-1 in the OSA patients with cognitive impairment was determined by receiver operating characteristic curve. Results Serum levels of Nrf2 and HO-1 in the mild-moderate and severe OSA groups were higher than those in the control group, and those in the severe OSA group were higher than those in the mild-moderate OSA group (P<0.05). Compared with the OSA with normal cognition group, the serum HO-1 level in the OSA patients with MCI was higher (P<0.05), but the serum NRF2 level had no significant difference between the two groups (P>0.05). There was a negative correlation between serum HO-1 level and total MoCA score in the OSA patients (r=–0.495, P=0.000), but there was no significant correlation between serum Nrf2 and total MoCA score in the OSA patients (P>0.05). Serum Nrf2 and HO-1 were 0.791 and 0.818 for predicting OSA patients with cognitive impairment. The sensitivity was 84.20% and 86.80%, and the specificity was 67.60% and 73.00%, respectively. Conclusions Serum Nrf-2 and serum HO-1 play important role in the pathogenesis of OSA. Serum HO-1 level may be closely related to cognitive dysfunction in OSA patients. Detection of serum HO-1 may be helpful in early identification of cognitive dysfunction in OSA patients, which has potential clinical application value.
Objectives This study aims to examine the possible association between C-reactive protein (CRP) concentration and cognitive impairment in patients with post-stroke epilepsy. Methods Patients with post-stroke epilepsy admitted to Western China Hospital from January 2010 to June 2016 were consecutively enrolled in our study. CRP levels were assessed within one week of stroke onset, and then correlated with cognitive status assessed two years after stroke using the Six-Item Screener. Results Among the 96 patients with post-stroke epilepsy who included in our study, 24 patients were found to have cognitive impairment during the two years follow-up period. Our data showed a significant association between CRP levels and cognitive performance in these patients (31.5±36.2 vs. 11.9±19.4, P=0.029). In addition, this association persisted even after adjusting for potential confounders［OR=1.021, 95%CI (0.997, 1.206), P=0.037］. Conclusions Following ischemic stroke, higher CRP levels is associated with subsequent cognitive decline in patients with epilepsy. Association and prospective studies in larger sample size are needed in order to validate our findings, especially studies in which baseline CRP level and CRP level during follow-up are closely monitored.
Atrial fibrillation, as the most common arrhythmia currently, can lead to secondary post-stroke cognitive dysfunction and chronic brain damage through various pathways, increasing the risk of cognitive dysfunction and affecting patient prognosis. The prevention and treatment drugs for cognitive dysfunction associated with atrial fibrillation mainly include anticoagulants, heart rhythm and heart rate control drugs, statins, and antihypertensive drugs. At present, there is still some controversy over the medication for cognitive dysfunction associated with atrial fibrillation, lacking guidelines and expert consensus. It is urgent and necessary to find safe, economical, and effective drugs to improve the cognitive function of atrial fibrillation patients. This article summarizes the recent advances in drug therapy for cognitive dysfunction associated with atrial fibrillation, in order to provide a reference for the treatment of cognitive dysfunction associated with atrial fibrillation in clinical practice.
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) in the elderly. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library databases were electronically searched for studies on the relationship between overweight, obesity/abdominal obesity, and CI in the elderly from their inception to July 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 15.0 software. ResultsA total of 38 studies involving 1 783 087 subjects were included. Meta-analysis results showed that compared with normal-weight individuals, overweight (OR=0.96, 95%CI 0.91 to 1.02, P=0.201) was not statistically significant in the risk of CI in the elderly. Obesity (OR=1.14, 95%CI 1.02 to 1.28, P=0.03) and abdominal obesity (OR=1.16, 95%CI 1.11 to 1.21, P<0.001) may be risk factors for CI in the elderly. Subgroup analysis was conducted based on study type, BMI standards, cognitive diagnostic standards, national development level, abdominal obesity diagnostic standards, and follow-up time. Among the subgroups analyzing the correlation between overweight and CI in the elderly, follow-up time ≤5 years (OR=0.68, 95%CI 0.58 to 0.80) showed a lower proportion of CI compared to other follow-up periods. In the subgroups analyzing the correlation between obesity and CI in the elderly, follow-up time ≤5 years (OR=0.71, 95%CI 0.50 to 1.01) was not statistically significant compared to other follow-up periods. For abdominal obesity, a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years (OR=1.21, 95%CI 1.15 to 1.27), compared with other follow-up periods. ConclusionCurrent evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly. Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.
Objective To systematically review the influencing factors of mild cognitive impairment in type 2 diabetic patients. MethodsPubMed, Web of Science, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect studies on the influencing factors of mild cognitive impairment in patients with type 2 diabetes from inception to December 31, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.4 software and Stata 12.0 software. ResultsA total of 32 studies involving 7 519 subjects were included. The results of the meta-analysis showed that the main influencing factors of mild cognitive impairment in type 2 diabetic patients were age, duration of type 2 diabetes, educational level, cerebral infarction, hypertension, smoking, insulin resistance index, glycosylated hemoglobin, and homocysteine. ConclusionCurrent evidence shows that some factors such as age, duration, and educational level are the main influencing factors of mild cognitive impairment in type 2 diabetic patients. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
Hypoxia and other factors are related to cognitive impairment. Hyperbaric oxygen therapy can improve tissue oxygen supply to improve brain hypoxia. Based on the basic principle of hyperbaric oxygen therapy, hyperbaric oxygen has been widely used in recent years for cognitive impairment caused by stroke, brain injury, neurodegenerative disease, neuroinflammatory disease and metabolic encephalopathy. This article will review the basic mechanism of hyperbaric oxygen, and summarize and discuss the improvement of hyperbaric oxygen therapy on cognitive and brain diseases, in order to provide relevant reference for clinical treatment.