Study on hyponatremia in patients with severe dementia / 中华老年医学杂志

Objective To investigate the incidence and outcome of hyponatremia in patients with severe dementia.Methods Dementia patients were retrospectively analyzed in 80 cases,including 45 patients with severe dementia complicating 30 cases of hyponatremia,and 35 patients with mild and moderate dementia complicating 5 cases of hyponatremia.The incidence rate of dementia patients complicating hyponatremia and its fatality rate were analyzed by x2 tests.The effect of dementia severity on hyponatremia and fatality rate was studied.Results The incidence rate of hyponatremia was higher in severe dementia patients (30 cases,66.7 ％) than in mild-moderate dementia patients (5 cases,14.3 ％) (x2 =21.95,P ＜ 0.01).The fatality rate of hyponatremia in severe dementia patients was higher(43.3％)than in patients with normal serum sodium(33.3 ％)(x2=0.25,P＞0.05).Conclusions Hyponatremia is more likely to occur in patients with severe dementia.However,hyponatremia does not affect survival time in the severe dementia patients.

Brain spontaneous activity alterations in patients with Alzheimer's disease and mild cognitive impairment / 中华神经科杂志

Objective To investigate the functional changes of brain spontaneous activity in patients with Alzheimer' s disease (AD) and amnestic mild cognitive impairment (aMCI) using resting-state functional magnetic resonance imaging (fMR1), and evaluate the potential value of fMRI marker in clinical diagnosis of AD and aMCI.Methods Twelve AD patients, 12 aMCI patients and 12 normal controls (NC) were assessed by the Minimum Mental State Examination (MMSE) and scanned using the resting-state fMRI.The fractional amplitude of low-frequency fluctuations (fALFF) method was employed to examine the changes of the brain spontaneous activity among the three groups.Results Significant between-group differences were found in the precuneus and the inferior parietal lobe.In the precuneus, the fALFF value in AD patients (mean ± SD : 1.11 ± 0.07) was significantly decreased as compared to NC (1.24 ± 0.11, t =2.89,P =0.012) and aMCI patients (1.34 ±0.17,t =3.49,P =0.004).The aMCI patients demonstrated numerically largest fALFF in the precuneus.In the inferior parietal lobe, the fALFF values in AD patients (0.96 ±0.07) were also significantly decreased as compared to NC (1.11 ±0.07 ,t =4.31 ,P =0.001) and aMCI patients (1.09 ± 0.08, t =3.44, P =0.004).Conclusions AD patients were mostly influenced in the specific regions in terms of brain spontaneous activity, while the aMCI patients showed a compensatory tendency in the precuneus.

Relationship between plasma heavy metal concentrations and Alzheimer's disease and vascular dementia / 国际脑血管病杂志

Objective To investigate the roles of heavy metals in the onset of Alzheimer 's disease (AD) and vascular dementia (VaD) and to analyze the relationship between cognitive impairment and plasma heavy metal concentrations in patients with AD. Methods Fifty patients with AD, 20 with VaD, and 20 healthy controls were included in the study. According to the Clinical Dementia Rating (CDR), the AD patients were divided into mild dementia (CDR = 1 )and moderate to severe dementia (CDR = 2 to 3 ) groups. All the observational subjects performed the Mini-Mental State Examination (MMSE) score, Hachinski ischemic index score,and CDR score. A fasting venous blood sample was taken from all the subjects for detection of the heavy metal (Tu, Ca, Fe, Me, Zn, Hg, Cr, Co, Se, and Pb) concentrations at the same time.Results Compared to the control group, the plasma Cu concentration in the mild dementia and moderate to severe dementia groups increased significantly (0. 66 ± 0. 2 1, 0. 84 ± 1.11, and 0. 85 ± 1.12 ng/g, respectively (P ＜ 0. 05). There was no significant difference between the mild AD group and the moderate to severe dementia group. The Pb concentration in the control group was significantly lower than that in the moderate to severe dementia group (22.79 ±3.94 ng/gvs. 40. 82 ± 16.96 ng/g, P ＜ 0. 05 ). While there were no significant differences between the control and the mild dementia and moderate to severe dementia groups. The plasma Cu concentration (0.84 ± 1.25 ng/g vs. 0. 66 ± 0.21 ng/g, P ＜＜ 0. 05) and Pb concentration (32.42 ± 14. 12 ng/gvs. 22.79 ± 3.94 ng/g, P ＜ 0. 05) in the AD group were significantly higher than that in the control group. While there was no significant difference between the VaD group and the control group for metal concentrations. There was also no significant difference for metal concentrations hetween the VaD group and the AD group. Conclusions Some heavy metals, such as Cu and Pb might have participated in the pathogenic process of AD, but the heavy metal concentrations did not have close relationship with the onset of VaD. There was no significant correlation between the degree of cognitive impairment and the plasma metal concentrations in patients with AD.

Cognitive change in schizophrenic patients with concomitant metabolism syndrome / 中华行为医学与脑科学杂志

Objective To explore cognitive change in schizophrenic patients with concomitant metabolism syndrome,and to provide theory basis for early intervention and treatment.Methods According to inclusion standard,56 schizophrenic inpatients with metabolism syndrome and 56 schizophrenic inpatients without metabolism syndrome were included.The matrics consensus cognitive battery(MCCB),stroop test,digit span,UPSA-B were used to assess the cognitive function.Results There were significant differences for test scores of symbol coding subtest,verbal memory subtest,digit sequence subtest,Maze subtest,continue performance among MCCB between schizophrenic patients with and without metabolism syndrome(27.07±10.46 vs 32.18±12.12,16.04±5.07 vs18.71±6.02,13.39±5.18 vs 15.79±5.48,1.38±0.66 vs 1.7±0.68,all P＜0.05),as well as stroop test and digit span test(31.14±11.68 vs 36.57±13.32,13.77±3.64 vs 15.82±4.38,P＜0.05 for both).Conclusion The schizophrenic patients with metabolism syndrome have severer cognitive impairment than those without metabolism syndrome.

Correlation between behavioural and psychological symptoms and cerebra white matter lesions in patients with Alzheimer's disease / 国际脑血管病杂志

Objective To investigate the correlation between behavioural and psychological symptoms and cerebral white matter lesions (WMLs) in patients with Alzheimer's disease (AD). Methods Sixty patients with AD aged more than 60 years (AD group) and 40 age-, sex-matched subjects with normal cognitive function (control group) were recruited. data of cerebral CT were analyzed blindly. The sum of WMLs in 8 regions, such as bilateral frontal region, parieto-occipital region, temporal region, and subtentorial region, etc were used as the total score of WMLs, and the cerebrovascular lesions revealed on CT were detected. The AD group was assessed with the Neuropsychiatric Inventory (NPI). Results There were significant differences in total WML score (1. 450 ±2. 310 vs. 9. 640 ± 1. 566, P =0. 000), left frontal WMLs (0. 340 ± 0. 340 vs. 1. 720 ± 0. 248, P = 0. 001), fight frontal WMLs (0. 310 ±0. 560 vs. 1. 680 ±0. 312, P =0. 001), left parieto-occipital WMLs (0. 240 ±0. 360 vs. 1. 550 ±0. 244, P =0. 012), right parieto-oecipital WMLs (0. 140 ±0. 230 vs. 1. 450 ± 0. 231, P = 0. 006) and cerebrovascular lesions (0. 120 ± 0. 330 vs. 2. 230 ± 0. 378, P = 0. 002) hetwsen the AD group and the control group. Spearman correlation analysis showed that NPI was correlated with the total WML score (rs =0. 487, P = 0. 016), left frontal WMLs (rs =0. 490, P = 0. 014), right frontal WMLs (rs = 0. 502, P = 0. 014), left parieto-occipital WMLs (rs =0. 507, P =0. 012) and right parieto-occipital WMLs (rs =0. 521, P = 0. 014), and it was not correlated with the cerebrovascular lesions (rs = 0. 132, P = 0. 590).Conclusions WMLs and cerebrovascular lesions are essential in the onset of AD and disease development. WMLs are closely correlated with the behavioural and psychological symptoms in patients with AD.

Clinical analysis of risk factors for falls in patients with dementia / 中华老年医学杂志

Objective To explore the risk factors for falls in patients with dementia. Methods Totally 118 patients diagnosed with dementia were divided into fails group and no fails group. The scores of mini-mental state examination (MMSE), clinical dementia rating (CDR) , activity of daily living scale (ADL), neuropsychiatric inventory (NPI) and unified Parkinson's disease rating scale (UPDRS) were compared between the two groups. The relationship between falls and their risk factors were analyzed by logistic regression model. Results The NPI and UPDRS scores were higher in falls group than in no falls group(t=2. 237,2. 213; both P<0.05). Multivariate analysis showed that dyskinesia and behavior disorders were significantly associated with an increased risk of falls (β=0.77 and 0.86, both P<0.05). Conclusions Dyskinesia and behavior disorders may be related to fails in patients with dementia and intervention measures of these risk factors are very essential.

Vascular Risk Factors and Alzheimer's Disease / 国际脑血管病杂志

Alzheimer's disease(AD),a most common type of dementia,often results in cognitive and behavioral dysfunction,A growing body of research suggested that there are specific correlations between AD and traditional vascular risk factors.There are significant associations between the incidence of AD and diabetes mellitus,hypercholesterolemia,hypertension,hyperhomocysteinemia,antioxidants,alcohol consumption,smoking,physical activity,and the presence of atrial fibrillation.These risk factors may he the potentially preventable etiologies of AD.