Factors of post-stroke dementia: A nationwide cohort study in Taiwan.

AIM: We investigated the long-term risk of dementia for up to 10 years in patients with stroke and broadened the correlates. METHODS: We carried out a case-control study using the Taiwan National Health Insurance Research database in 2000 with a sampled population of 1 million. The study cohort comprised 8236 patients with stroke and no dementia history. We carried out a 1:1 case-control matched analysis on estimated propensity scores. Cox proportional hazards regressions were carried out to estimate the risk of dementia during the 5- and 10-year follow-up periods. The risk factors were also investigated. RESULTS: The stroke cohort was significantly at more risk of dementia during the 5- and 10-year follow-up periods, with adjusted hazard ratios 1.87 and 1.53, respectively. The patients with ischemic stroke, transient ischemic attack and intracerebral hemorrhage had a significantly higher risk of dementia after 5 and 10 years, with adjusted hazard ratios of 1.81 and 1.49, 1.92 and 1.61, and 2.14 and 1.61, respectively. The significant risk factors of dementia were age ≥60 years, resident in southern and eastern regions, having low insurance range, and antiplatelet use. CONCLUSIONS: Stroke and the subtypes, including ischemic stroke, transient ischemic attack and intracerebral hemorrhage, increase the long-term risk of dementia. The incidence of post-stroke dementia increases yearly, but the relative risk decreases gradually. Older adults, residents in southern and eastern regions, having low insurance range and antiplatelet use were prominent risk factors of post-stroke dementia in Taiwan. Careful management of stroke and risk factors of post-stroke dementia with long-term follow up of cognition should be reinforced. Geriatr Gerontol Int 2019; 19: 815-822.

Effects of multiple training modalities in the elderly with subjective memory complaints: A pilot study.

BACKGROUND: This study investigated the effects of multiple training modalities (MTM) on senior fitness and neuropsychiatric function in the elderly with subjective memory complaints (SMC). METHODS: This study was conducted in 24 elderly subjects with Clinical Dementia Rating (CDR) score of 0 and instrument of ascertainment of dementia 8 (AD8) score of <2. The participants were classified into SMC (n = 7) and non-SMC (n = 17).All were assigned to receive multiple training modalities (1 hour for each training: physical fitness activities, calligraphy or drawing, and meditation) twice a week over a 16-week period.A series of senior fitness test, and neuropsychiatric tests, namely the Traditional Chinese version Mini-Mental Status Examination (MMSE), Cognitive Assessment Screening Instrument (CASI), and the Center for Epidemiologic Studies Depression Scale (CESD), were conducted before and after the intervention. We compared the differences of pre/posttest-MTM and SMC/non-SMC in senior fitness and the neuropsychological tests. RESULTS: There was no significant difference between SMC and non-SMC groups in demographic characteristics. MTM showed significant improvement in senior fitness and CESD, but not in CASI and MMSE. Significant change in recent memory subscale of CASI was only observed in SMC group, whereas improvement of partial senior fitness and CESD were observed in both groups. CONCLUSION: MTM had effects in enhancing senior fitness and improving depressive syndromes in the elderly. MTM contributed to greater improvement in recent memory function in the SMC group than in the non-SMC group.

Effects of multiple training modalities in patients with Alzheimer's disease: a pilot study.

OBJECTIVE: This pilot study investigated the effects of multiple training modalities on cognition, neuropsychiatric symptoms, caregivers' burden, and quality of life in patients with Alzheimer's disease (AD). PATIENTS AND METHODS: This intervention study was conducted in 24 patients with AD aged ≥65 years with a Clinical Dementia Rating (CDR) score of 0.5-1. The patients were assigned to receive multiple training modalities (1 hour for each training: Tai Chi, calligraphy, and drawing) over a 6-week period in either the experimental group (n=14) or the comparison group (n=10). A series of neuropsychological tests - namely the Traditional Chinese version Mini-Mental Status Examination, Cognitive Assessment Screening Instrument (CASI), Neuropsychiatric Inventory and the Neuropsychiatric Inventory Caregiver Distress Scale, and the Clinical Dementia Rating Sum of Boxes scale - were conducted at the baseline and after the intervention. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) and Zarit Caregiver Burden Scale were used to assess the quality of life and caregivers' burden, respectively. Independent sample t-test and paired sample t-test were used to analyze the data. RESULTS: After the intervention, the experimental group reported higher scores in the orientation domain of CASI (P=0.007) and in the psychiatry domain of WHOQOL-BREF (P=0.042) compared with the comparison group. Caregivers' distress was significantly decreased in the experimental group (P=0.035) but not in the comparison group (P=0.430). CONCLUSION: The multiple training modalities improved scores in the orientation domain of CASI and psychiatry domain of WHOQOL-BREF in patients with AD. Moreover, the intervention reduced caregivers' distress.

Adjunct effect of music therapy on cognition in Alzheimer's disease in Taiwan: a pilot study.

PURPOSE: Music therapy (MT) reviews have found beneficial effects on behaviors and social interaction in Alzheimer's disease (AD) but inconsistent effects on cognition. The purpose of the study was to evaluate the adjunct effect of long-term and home-based MT in AD patients under pharmacological treatment. PATIENTS AND METHODS: Mild AD cases (clinical dementia rating =0.5~1) were consecutively recruited and voluntarily separated into an MT group or control group (CG) for 6 months. Outcome assessments included Cognitive Abilities Screening Instrument (CASI), CASI-estimated mini-mental state examination, clinical dementia rating with sum of box scores, and neuropsychiatric inventory. The MT interventions were Mozart's Sonata (KV 448) and Pachelbel's Canon, listening with headphones for 30 minutes daily in the morning and before sleep, respectively. RESULTS: Forty-one cases (MT versus CG number =20 versus 21) were analyzed. Adjusted differences of CASI-estimated mini-mental state examination and CASI after 6 months in the MT group were slightly less decreased than the CG without statistical significance. In further analysis of cognitive domains of CASI, the adjusted difference of abstraction domain in the MT group was significantly better than the CG. CONCLUSION: Although there were no apparent additional benefits of this MT on the global cognition and daily functioning in mild AD patients, it confirms the adjunct cognition effect on the abstraction. This MT contributes to the supplementary treatment of AD.

Fast quantification of S-adenosyl-L-methionine in dietary health products utilizing reversed-phase high-performance liquid chromatography: teaching an old method new tricks.

S-adenosyl-L-methionine is a ubiquitous methyl donor in living bodies. It is known to participate in several physiological processes including homocysteine metabolism and glutathione synthesis regulation, and cellular antioxidant mechanism. S-adenosyl-L-methionine containing dietary supplements has been prescribed recently for the treatment of depression, arthritis, and liver diseases with encouraging results. The development of an efficient analytical protocol for S-adenosyl-L-methionine containing dietary supplements is crucial for maintaining product quality and consumer health. In this study, the S-adenosyl-L-methionine content of several yeast products and commercial healthy food product samples was quantitatively analyzed utilizing HPLC. The chromatographic separation was achieved on a reversed-phase column and 2 % acetonitrile with a 98 % ammonium-acetate mobile phase under pH 4.5, with a flow rate of 1.0 mL/min. The wavelength used for detection with the UV detector was 254 nm. The total analysis time was short and the target compound showed a well-defined peak. The correlation coefficient of the regression curve showed good linearity and sensitivity with r = 0.999. All experiments were replicated five times and the relative standard deviations as well as the relative error values were all less than 3 %. Moreover, the achieved precision and accuracy values were high with 97.4-100.9 % recovery. Qualitative determination of S-adenosyl-L-methionine in the tested products was achieved using NMR and LC-MS techniques. The developed protocol is robust, fast, and suitable for the quality control analysis of yeast and commercial S-adenosyl-L-methionine products.

A meta-analysis of hypnosis in the treatment of depressive symptoms: a brief communication.

The efficacy of hypnosis in the treatment of depressive symptoms was subjected to a meta-analysis. Studies were identified using Google Scholar and 6 electronic databases: PubMed, Cochrane Library, PsiTri, PsychLit, Embase, and the Cochrane Depression, Anxiety and Neurosis Review Group (CCDAN). The keywords used were (a) hypnosis, (b) hypnotherapy, (c) mood disorder, (d) depression, and (e) dysthymia. Six studies qualified and were analyzed using the Comprehensive Meta-Analysis software package. The combined effect size of hypnosis for depressive symptoms was 0.57. Hypnosis appeared to significantly improve symptoms of depression (p < .001). Hypnosis appears to be a viable nonpharmacologic intervention for depression. Suggestions for future research are discussed.