Using structural equation modeling to detect response shift in quality of life in patients with Alzheimer's disease.

ABSTRACTBackground:Our study aims to detect different types of response shifts (RS) and true changes of quality of life (QOL) measurement in patients with Alzheimer's disease (AD) using structural equation modeling (SEM) in domain level. METHODS: Patients with AD aged over 60 years old were collected from the Department of Neurology and Geriatrics in Taiyuan Central Hospital, China. The 12-item Short Form (SF-12) Health Survey was measured in 238 patients with AD prior to hospitalization and one month following discharge. RS was detected by SEM approach. The statistical process consisted of four steps and fitted four models. We interpreted changes of parameters in models to detect RS and to assess true change. RESULTS: The results showed reprioritization of social functioning (SF) (χ2 = 4.13, p < 0.05), reconceptualization of role limitations due to emotional problems (RE) (χ2 = 17.03, p < 0.001), uniform recalibration of bodily pain (BP) (χ2 = 12.24, p < 0.001), and non-uniform recalibration of mental health (MH) (χ2 = 4.41, p < 0.05), respectively. The true changes of common factors were deteriorated in general physical health (PHYS) (-0.10, χ2 = 8.30, p < 0.005) and improved in general mental health (MENT) (+0.29, χ2 = 20.95, p < 0.001). The effect-sizes of RS were only small. CONCLUSION: This study showed that patients with AD occurred three types of RS and true changes one month following discharge. RS had effects on the QOL of patients. Better understanding of potential changes in QOL in patients with AD is crucial.

Caregiver burden in Alzheimer's disease: Moderation effects of social support and mediation effects of positive aspects of caregiving.

OBJECTIVES: Although there are many studies on the relationship between patient-related factors and negative caregiver outcomes, the specifics of this relationship are poorly understood. We aimed to examine whether caregiver social support moderated the relationship between patient factors and negative outcomes for caregivers of community-dwelling older adults with Alzheimer's disease (AD), and whether positive aspects of caregiving mediated this relationship. METHODS: We conducted a cross-sectional study of patients diagnosed with AD from 2 hospitals and 3 communities in Taiyuan, China, and their caregivers. Latent moderated structural equations and the bias-corrected percentile bootstrap method were used to estimate the parameters of moderating and mediating effects, respectively. RESULTS: Social support significantly moderated the effects of AD patient cognitive function (P < 0.001) and depression (P = 0.001) on caregiver burden. Positive aspects of caregiving completely mediated the association between patient depression and caregiver burden (P = 0.006), caregiver anxiety (P = 0.007), and caregiver depression (P = 0.034). CONCLUSIONS: The findings identify social support as a moderator and positive aspects of caregiving as a mediator of the relationship between patient-related factors and negative caregiver outcomes. The results suggest that health care providers must offer more effective social support for caregivers. In addition, prompt identification of patient and caregiver emotional states could help to improve quality of life.

Trajectories of health-related quality of life during the natural history of dementia: a six-wave longitudinal study.

OBJECTIVE: The objective of this study was to explore profiles of quality of life (QoL) trajectories during the natural history of dementia and individual variations contributing to QoL trajectories. METHODS: We conducted a longitudinal community-based study of 520 elderly people with mild cognitive impairment and 100 healthy people aged 60 years or over. We conducted six waves of assessment between October 2010 and May 2013 in Taiyuan, mainland China. Cognitively normal, mild cognitive impairment, global impairment, and Alzheimer's disease (AD) were defined as state 1, 2, 3, and 4, respectively. We assessed health-related QoL (HRQoL) via the Quality of Life-Alzheimer's Disease (QoL-AD) Chinese version. We used the latent growth curve model (LGCM) to investigate change in HRQoL over time. RESULTS: Latent growth curve model analysis revealed a mean initial QoL level of 29.865 with substantial variation and a significant mean slope for the whole sample. Multigroup LGCM showed substantial variations across individuals in initial QoL levels for each cognitive state transition group. For the slope factor, we found significant changes and variations for the transition from state 2 to 3 and from state 3 to 4. We estimated mean QoL levels over six assessments based on intercept, slope, and factor loadings for the whole sample and the three cognitive state transition groups. CONCLUSIONS: A decline in subjective QoL is not inevitable during the natural history of dementia in community settings, and there is a degree of individual variation in QoL. Future studies should investigate the factors associated with individual variations in QoL trajectories in AD.

Risk factors of transition from mild cognitive impairment to Alzheimer's disease and death: A cohort study.

BACKGROUND: Knowledge of risk factors is essential for developing strategies that prevent or minimise transitions from mild cognitive impairment (MCI) to Alzheimer's disease (AD) and death. The aim of this study was to assess risk factors for progression to AD and death among Chinese individuals with cognitive impairment. METHODS: We conducted a multisite, population-based cohort study on 437 community-dwelling elderly MCI residents in Taiyuan, China from 2010 to 2014. MCI, AD, death from AD and death from a cause other than AD were specified as disease states during the natural history of dementia. Transition-specific Cox model was fitted and hazard ratio (HR) with 95% confidence intervals (CIs) was estimated. RESULTS: Analyses showed that risk factors played different roles in affecting transitions to AD and death. Risk factors for transition from MCI to AD were being female (HR: 1.82; 95%CI: 1.20-2.77), older age (HR: 3.09; 95%CI: 1.81-5.25), reading occasionally (HR: 1.79; 95%CI: 1.11-2.89), current smoking (HR: 1.74; 95%CI: 1.15-2.65), light-moderate alcohol drinker (HR: 2.24; 95%CI: 1.42-3.53), cerebrovascular disease (HR: 2.70; 95%CI: 1.68-4.34), hyperlipidemia (HR: 1.87; 95%CI: 1.16-3.02) and diabetes (HR: 1.81; 95%CI: 1.18-2.77). Only cerebrovascular disease (HR: 3.04; 95%CI: 1.22-7.58) was a significant risk factor for transition from MCI to death from a cause other than AD. Older age (HR: 10.68; 95%CI: 1.16-97.93) and low level education (HR: 0.14; 95%CI: 0.05-0.44) were significant predictors for transition from AD to death from a cause other than AD. CONCLUSIONS: Participants with advanced age, low-level education, history of harmful alcohol consumption or smoking, cerebrovascular disease, hyperlipidemia, diabetes or who were female were at increased risk of transitioning to AD or death. Strategies to control modifiable risk factors in specific disease stage should be implemented to decrease the conversion to AD or death among Chinese patients with MCI.

Reliability and validity of the quality of life-Alzheimer disease Chinese version.

OBJECTIVES: To evaluate the psychometric properties of the quality of life-Alzheimer disease (QOL-AD) Chinese version in patients with dementia in mainland, China and to compare patient and caregiver reports of patient QOL. METHODS: The QOL-AD Chinese version was established following standard guidelines for cross-cultural adaptation of measures. The reliability was assessed by internal consistency and test-retest reliability. The validity included construct and convergent validity. A paired Student t test was performed to determine differences between patient reports and caregiver reports. RESULTS: The reliability for both patient and caregiver reports on the QOL-AD was good (Cronbach α values of 0.66 and 0.87; intraclass correlation coefficients of 0.84 and 0.90 for patient and caregiver reports, respectively). The validity of patient and caregiver reports was supported by correlation with domain measures. All of the multitrait-multimethod correlations demonstrated a high relationship between patient reports and caregiver reports, ranging from 0.26 to 0.55. The caregivers rated patient QOL significantly higher than did the patients. CONCLUSION: The findings support the use of the Chinese version of the QOL-AD as a generic instrument to measure QOL of AD in mainland China. Further research is needed to clarify the relationship between patient and caregiver reports of patient QOL.

[Relationships between stoichiometric characteristics of soil enzymatic activities and environmental factors in parallel valleys of western Yunnan, China.] / æ»‡è¥¿å¹¶æµæ²³è°·åŒºåœŸå£¤é ¶æ´»æ€§åŒ–å­¦è®¡é‡å­¦ç‰¹å¾ä¸ŽçŽ¯å¢ƒå› å­çš„å ³ç³».

The valleyes of Hengduan Mountains contain the landscapes with high heterogeneity as well as high diversity of climate and vegetation types. To explore the soil cycling of four elements (C, N, P, S) across the parallel valleys of Nujiang River, Lancang River, Jinsha River and Yuanjiang River in western Yunnan, we collected top soils (0-10 cm) in forests, grasslands, and croplands. The activities of soil enzymes, including ß-glucosidase (BG), ß-N-acetylglucosaminidase (NAG), acid phosphatase (AP), and sulfatase (SU), which drive the soil C, N, P and S cycling, were determined. We analyzed the relationships of soil enzymatic activities and their stoichiometric characteristics with environmental factors. The activities of both AP and NAG had significant difference among different basins and different land types. The activities of AP, BG, NAG and SU were significantly positively related with each other. From southeast to northwest, the activities of BG, NAG, and SU increased with the altitude. Across all basins, the ecoenzymatic ratios of soils always ranked as AP:SU > BG:SU > NAG:SU > BG:NAG > BG:AP > NAG:AP. Compared with forest and grassland soil, cropland soils in each watershed had a higher BG:NAG and a lower NAG:AP (except Yuanjiang River basin). Moreover, AP:SU, BG:SU and NAG:SU of cropland soils were lower than those of forest and grassland in Yuanjiang River basin. However, they were higher than forest and lower than grassland in both Lancang River basin and Jinsha River basin. Soil enzyme activities and enzymatic stoichiometry were affected by physicochemical properties of soil, climate, and location, with the most contribution from soil physicochemical properties. Agricultural land use significantly affected the stoichiometry of C:N:P acquiring enzymes in soils by reducing the activity of N-degrading enzymes relative, resulting in the increases of BG:NAG and the decreases of NAG:AP. Agricultural activities had limited effects on other enzymatic stoichiometries.

Higher soil fauna abundance accelerates litter carbon release across an alpine forest-tundra ecotone.

Upward shifts of alpine treelines and shrub expansion are occurring under climate change, and Abies faxoniana (AF) and Rhododendron lapponicum (RL) may become distributed at higher altitudes. How do abiotic factors and litter quality modulate the effects of soil fauna on carbon release in this context? A field decomposition experiment involving the foliar litter of AF and RL was conducted along an elevation gradient encompassing coniferous forest, alpine shrubland and alpine meadow by using litterbags with different mesh sizes (3 and 0.04 mm). The objective was to determine the influences of soil fauna, litter quality and abiotic factors on species-specific carbon release and their contributions during litter decomposition. Our findings demonstrated that higher soil fauna abundance and diversity facilitated litter carbon release. The contribution rates of soil fauna to carbon release (Cfau) decreased with elevation increasing and decomposition time. Cfau are influenced by soil faunal diversity, dominant fauna groups (Collembola, Oribatida, Mesostigmata), and abiotic factors (temperature). Soil fauna significantly and directly regulated carbon release, abiotic factors indirectly regulated carbon release via altering soil fauna community composition and litter quality. This study improve our understanding in the mechanisms of decomposer contributions to carbon cycling in the context of global climate change.

Microclimate exerts greater control over litter decomposition and enzyme activity than litter quality in an alpine forest-tundra ecotone.

Plant litter decomposition is an important biogeochemical process in terrestrial ecosystems. Although climate and substrate quality controls over litter decomposition are reasonably well understood, their impacts on lignocellulose degradation and lignocellulolytic enzymes remain elusive. Here, the decomposition of three leaf litters derived from Salix paraplesia (SP), Deyeuxia scabrescens (DS), and Ajuga ovalifolia (AO), was studied across an alpine forest-tundra ecotone during one snow-covered season with the objective of distinguishing between the effects of microclimate and litter quality on litter decomposition rates and lignocellulolytic enzymes. The results showed that both microclimate and litter quality affected lignocellulose degradation rates and lignocellulolytic enzyme activities; however, microclimate factors had the greater effects. Interestingly, freeze-thaw cycles and moisture were the predominant factors explaining the variations in decomposition rate and enzyme activities. Higher cellulose degradation rates were associated with higher cellulose concentrations. Cellulolytic enzymes had a greater effect on litter decomposition than did ligninolytic enzymes at the early decomposition stage. Litter decomposition and enzyme activities should be given more attention under global climate change, as the direction and magnitude of changes in microclimate factors and litter quality could strongly influence the nutrient cycling and energy fluxes of alpine ecosystems.

Moderating role of positive aspects of caregiving in the relationship between depression in persons with Alzheimer's disease and caregiver burden.

Improving caregivers' positive perception of their role may be important in reducing their subjective burden when caring for Alzheimer's disease (AD) patients with depression. The purpose of present study was to explore the moderating role of the positive aspects of caregiving (PAC) on the subjective burden on family caregivers when managing depressive behaviors. We conducted a cross-sectional study including 200 pairs of patients with mild AD and their caregivers from three communities and two hospitals in Taiyuan, China in October 2014. The latent variable interaction model based on a two stage least squares (2SLS) regression was fitted. A significant moderating effect of the PAC was found on the relationship between depression in patients with AD and the caregiver burden they cause. Caregivers dealing with patients with low levels of depression but with high levels of the PAC had significantly lower levels of caregiver burden compared to those caregivers with the low levels of PAC. Continuously detecting the patient's mental state combined with caregivers having an optimistic attitude towards life may improve the quality of life for both patients and caregivers.

The relationship between cognition and depressive symptoms, and factors modifying this association, in Alzheimer's disease: A multivariate multilevel model.

OBJECTIVES: To examine whether there was a bidirectional association between cognition and depressive symptoms in Alzheimer's disease (AD), and to explore the role of socio-demographic factors and daily performance in this association. METHODS: We conducted a longitudinal study of 104 community-dwelling patients with confirmed AD from Taiyuan, China. We assessed cognition and depressive symptoms (dependent variables) with the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale-30 (GDS-30), respectively. Socio-demographic information and daily performance were treated as explanatory variables. A multivariate multilevel model was built to investigate the interrelationship between patients' cognition and depression, as well as the effect of related factors on both outcomes. RESULTS: MoCA scores were negatively correlated with GDS-30 both at the subject level (correlation coefficient r3=-0.68, χ2=19.26, P<0.001) and time point level (r2=-0.35, χ2=35.68, P<0.001) in patients with AD. Multivariate analysis showed several significant factors for cognitive function, including educational level, personality, hobbies, exercise, reading, aluminum utensil use, dietary restriction and hypertension (regression coefficients: 0.60, 0.52, 0.51, 0.48, 0.45, -0.48, 0.67, and -0.74, respectively). Significant factors for depressive symptoms included family status, employment before retirement, homemaking, reading, aluminum utensil use, dietary restriction, and hypertension (regression coefficients: 3.09, -1.33, -1.62, -1.31, 0.96, -1.15, and 1.14, respectively). CONCLUSION: These findings indicated that cognition was negatively associated with depression in patients with AD, and both were influenced by reading, aluminum utensil use, dietary restriction, and hypertension. Considering patient factors may help to slow the progression of dementia.

Measuring the Caregiver Burden of Caring for Community-Residing People with Alzheimer's Disease.

OBJECTIVES: To assess the direct and indirect effects of patient or caregiver factors on caregiver burden of caring for community-residing people with mild Alzheimer's disease (AD). METHODS: We conducted a cross-sectional study of patients diagnosed with AD from two hospitals and three communities in Taiyuan, China and their caregivers. For this survey, 200 patients with mild AD and their caregivers were selected. Caregivers were asked to provide sociodemographic information including age, gender, relationship with the patient, level of education, and number of contact hours per week with the patient. Caregiver burden was assessed using the Caregivers Burden Inventory. The caregivers also completed other measures including the Positive Aspects of Caregiving, the Family Adaptation, Partnership, Growth, Affection, and Resolve, and the Social Support Rating Scale. The patients with AD completed the Montreal Cognitive Assessment; their caregivers completed the Activities of Daily Living Scale and a questionnaire about the patients' Behavioral and Psychological symptoms of Dementia. The main outcome in this study was caregiver burden. The care receivers' level of cognitive function, physical function, and behavioral problems were treated as original stress; the primary appraisal variable was measured as the number of hours of caregiving in the previous week reported by the caregiver. Mediator variables included perceived social support, family function, and caregiving experience. Path analysis was used to build the interrelationship among caregiver burden and patient or caregiver factors. RESULTS: A lower level of cognitive function in patients (r = -0.28, p<0.001) and longer hours of caregiving (r = 0.17, p = 0.019) were related to increased caregiver burden. Greater social support (r = -0.23, p<0.001), family function (r = -0.17, p = 0.015) and caregiving experience (r = -0.16, p = 0.012) were related to decreased caregiver burden. Social support (r = 0.16, p = 0.040) and family function (r = 0.25, p = 0.002) were directly related to patients' level of cognitive functioning, but were mediator factors between level of cognitive function in patients and caregiver burden. Similarly, social support was a mediator factor between patients' daily function (r = -0.23, p = 0.004) and caregiver burden; while caregiving experience mediated the link between behavioral and psychological symptoms in patients (r = 0.36, p<0.001) and caregiver burden. CONCLUSION: Level of cognitive function and hours of caregiving were directly related to caregiver's burden. Social support, family function and caregiving experience could mediate the relationship between patient factors and caregiver burden. Focusing on patient factors and promoting caregiver care will be helpful in lowering the perceived burden of caregiving.

[Relationships between decomposition rate of leaf litter and initial quality across the alpine timberline ecotone in Western Sichuan, China].

The relationships between litter decomposition rate and their initial quality of 14 representative plants in the alpine forest ecotone of western Sichuan were investigated in this paper. The decomposition rate k of the litter ranged from 0.16 to 1.70. Woody leaf litter and moss litter decomposed much slower, and shrubby litter decomposed a little faster. Then, herbaceous litters decomposed fastest among all plant forms. There were significant linear regression relationships between the litter decomposition rate and the N content, lignin content, phenolics content, C/N, C/P and lignin/N. Lignin/N and hemicellulose content could explain 78.4% variation of the litter decomposition rate (k) by path analysis. The lignin/N could explain 69.5% variation of k alone, and the direct path coefficient of lignin/N on k was -0.913. Principal component analysis (PCA) showed that the contribution rate of the first sort axis to k and the decomposition time (t) reached 99.2%. Significant positive correlations existed between lignin/N, lignin content, C/N, C/P and the first sort axis, and the closest relationship existed between lignin/N and the first sort axis (r = 0.923). Lignin/N was the key quality factor affecting plant litter decomposition rate across the alpine timberline ecotone, with the higher the initial lignin/N, the lower the decomposition rate of leaf litter.

[Litter decomposition and soil faunal diversity of two understory plant debris in the alpine timberline ecotone of western Sichuan in a snow cover season].

In order to understand the relationship between litter decomposition and soil fauna diversity during snow cover season, litterbags with plant debris of Actinothuidium hookeri, Cystopteris montana, two representative understory plants in the alpine timberline ecotone, and their mixed litter were incubated in the dark coniferous forest, timberline and alpine meadow, respectively. After a snow cover season, the mass loss and soil fauna in litterbags were investigated. After decomposition with a snow cover season, alpine meadow showed the highest mass loss of plant debris in comparison with coniferous forest and timberline, and the mass loss of A. hookeri was more significant. The mixture of two plants debris accelerated the mass loss, especially in the timberline. A total of 968 soil invertebrates, which belonged to 5 classes, 10 orders and 35 families, were captured in litterbags. Acarina and Collembola were the dominant groups in plant debris. The numbers of individuals and groups of soil faunal communities in litter of timberline were higher than those of alpine meadow and dark coniferous forest. Canonical correspondence analysis (CCA) indicated that the groups of soil animals were related closely with the average temperature, and endemic species such as Isoptera and Geophilomorpha were observed only in coniferous forest, while Hemiptera and Psocoptera only in.the alpine meadow. The diversity of soil faunal community was more affected by plant debris varieties in the timberline than in the coniferous forest and alpine meadow. Multiple regression analysis indicated that the average temperature and snow depth explained 30.8% of the variation of litter mass loss rate, soil animals explained 8.3%, and altogether explained 34.1%. Snow was one of the most critical factors impacting the decomposition of A. hookeri and C. montana debris in the alpine timberline ecotone.

[Litter decomposition and lignocellulose enzyme activities of Actinothuidium hookeri and Cys- topteris montana in alpine timberline ecotone of western Sichuan, China].

The mass loss and lignocellulose enzyme activities of Actinothuidium hookeri residues and Cystopteris montana leaf litter in coniferous forest and timberline of western Sichuan, China were investigated. The results showed that both the mass loss rates of A. hookeri and C. Montana in timberline were higher than those in coniferous forest, while enzyme activities in timberline were lower than those in coniferous forest which was contrast with the hypothesis. The mass loss of two ground covers had significant differences in different seasons. The mass loss rate of A. hookeri in snow-covered season accounted for 69.8% and 83.0% of the whole year' s in timberline and coniferous forest, while that of C. montana in the growing season accounted for 82.6% and 83.4% of the whole year' s in timberline and coniferous forest, respectively. C. montana leaf litter decayed faster in the growing season, which was consistent with its higher cellulase activity in the growing season. The result illustrated that the enzymatic hydrolysis of cellulose and hemicellulose might be the main driving force for the early stage of litter decomposition. Multiple linear regression analysis showed that environmental factors and initial litter quality could explain 45.8%-85.1% variation of enzyme activity. The enzyme activities of A. hookeri and C. montana in the process of decomposition were mainly affected by the freeze-thaw cycle in snow-covered season.

Involvement of p38 MAPK in reactive astrogliosis induced by ischemic stroke.

Reactive astrogliosis is an essential feature of astrocytic response to all forms of central nervous system (CNS) injury and disease, which may benefit or harm surrounding neural and non-neural cells. Despite extensive study, its molecular triggers remain largely unknown in term of ischemic stroke. In the current study we investigated the role p38 mitogen-activated protein kinase (MAPK) in astrogliosis both in vitro and in vivo. In a mouse model of middle cerebral artery occlusion (MCAO), p38 MAPK activation was observed in the glia scar area, along with increased glial fibrillary acidic protein (GFAP) expression. In primary astrocyte cultures, hypoxia and scratch injury-induced astrogliosis was attenuated by both p38 inhibition and knockout of p38 MAPK. In addition, both knockout and inhibition of p38 MAPK also reduced astrocyte migration, but did not affect astrocyte proliferation. In a mouse model of permanent MCAO, no significant difference in motor function recovery and lesion volume was observed between conditional GFAP/p38 MAPK knockout mice and littermates. While a significant reduction of astrogliosis was observed in the GFAP/p38 knockout mice compared with the littermates. Our findings suggest that p38 MAPK signaling pathway plays an important role in the ischemic stroke-induced astrogliosis and thus may serve as a novel target to control glial scar formation.

[Item function analysis on the Quality of Life-Alzheimer's Disease(QOL-AD)Chinese version, based on the Item Response Theory(IRT)].

OBJECTIVE: To introduce the Item Function Analysis(IFA) of Quality of Life- Alzheimer's disease(QOL-AD)Chinese version and to explore the feasibility of its application on Chinese patients with AD. METHODS: Two hundred AD patients were interviewed and assessed by QOL-AD, through the stratified cluster sampling method. Multilog 7.03. was used for Item Function Analysis. Difference scale(a), difficulty scale(b)and Item Characteristic Curve(ICC) of each item of QOL-AD were provided. RESULTS: Different scales of the item 1, 7 were below 0.6, while all the others were above 0.6. As for ICC. The first and last lines for the other items were monotonic in which the two in between were in inverted V-shape, with very steep slopes, except for the item 1 and 7. CONCLUSION: Results form the IFA showed that QOL-AD was applicable to be used in the Chinese patients with AD.

Astroglial PTEN Loss Disrupts Neuronal Lamination by Dysregulating Radial Glia-guided Neuronal Migration.

PTEN plays an important role not only in tumorigenesis but also in the normal development of central nervous system. PTEN loss in neural progenitor cells during embryogenesis disrupts migration and proper formation of the brain laminar structure. We generated a conditional PTEN knockout mouse by crossing mice that express Cre recombinase driven by the human GFAP promoter to a floxed PTEN gene to investigate the role of astroglial PTEN signaling pathway in neuronal patterning and lamination. We found PTEN loss not only in astroglial cells, but also in radial glia-derived neurons in hGFAP-Cre(+/-)/PTEN(loxp/loxp) transgenic mice. Homozygous hGFAP-Cre(+/-)/PTEN(loxp/loxp) transgenic mice showed progressive brain enlargement with cellular disorganization that occurred predominantly in hippocampus and cerebellum and died by postnatal day 20. Confocal images show that nestin-positive radial glial cells were observed in the hippocampus, cortex, and cerebellum at postnatal day 0 in homozygous hGFAP-Cre(+/-)/PTEN(loxp/loxp), but not in heterozygous hGFAP-Cre(+/-)/PTEN(loxp/-) and hGFAP-Cre(-/-)/PTEN(loxp/loxp) mice. Homozygous hGFAP-Cre(+/-)/PTEN(loxp/loxp) transgenic mouse eyes, which lack radial glial lineage, were able to develop normal architectonics after birth. In addition, we also found that neuronal progenitor migration was defected at postnatal day 0 in homozygous hGFAP-Cre(+/-)/PTEN(loxp/loxp) mice. These results suggest that PTEN has a critical role in regulating radial glial differentiation, proliferation, maturation, and eventually neuronal patterning in central nervous system in a spatio-temporal dependent manner.

[Current status and influencing factors regarding quality of life among patients with Alzheimer's disease].

OBJECTIVE: To investigate the current status and influencing factors regarding quality of life among patients with Alzheimer's disease (AD). METHODS: Through stratified cluster sampling method, two hundred patients with AD and their caregivers were chosen and interviewed. AD patients were assessed by questionnaires, Montreal Cognitive Assessment, and Quality of Life-Alzheimer's Disease (QOL-AD), in order to compare the reports from patients and caregivers on QOL-AD and to analyze related influencing factors. Descriptive analysis, paired t-test, analysis of variance (ANOVA), Pearson's correlation and multiple linear regression were performed using the Statistical Package for Social Science (SPSS). RESULTS: The scores of reports from patients (28.78 ± 4.30) were lower than that from the caregivers' (30.05 ± 6.05). The difference was statistically significant (t = 2.122, P < 0.05) and was positively correlated (r = 0.312, P < 0.001). Data from multivariate analysis showed that cognitive level (t = 3.465, P = 0.001), marriage relationship (t = 3.062, P = 0.003), having public activities (t = 2.581, P = 0.011), personal characters (t = 2.254, P = 0.026), restricted diet pattern (t = 3.614, P < 0.001), regularly drinking tea (t = 2.652, P = 0.009) and doing housework (t = 3.180, P = 0.002) were predictive factors. CONCLUSION: Scores from the caregiver's report on QOL-AD were higher than that from the patients'. Many factors influenced the quality of life on AD patients. Strategies on improving the quality of life among AD patients can be developed based on the findings of this study.