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1.
Physiol Behav ; : 114579, 2024 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-38710351

RESUMEN

Olfactory and cognitive performance share neural correlates profoundly affected by physiological aging. However, whether odor identification and discrimination scores predict global cognitive status and executive function in healthy older people with intact cognition is unclear. Therefore, in the present study, we set out to elucidate these links in a convenience sample of 204 independently living, cognitively intact healthy Czech adults aged 77.4 ± 8.7 (61 - 97 years) over two waves of data collection (one-year interval). We used the Czech versions of the Montreal Cognitive Assessment (MoCA) to evaluate global cognition, and the Prague Stroop Test, Trail Making Test, and several verbal fluency tests to assess executive function. As a subsidiary aim, we aimed to examine the contribution of olfactory performance towards achieving a MoCA score above vs. below a published cut-off value. Our findings demonstrate that olfaction, on the one hand, and global cognition and executive function, on the other, are related even in healthy older people.

2.
BMC Psychiatry ; 24(1): 309, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38658884

RESUMEN

BACKGROUND: Lateral ventricular enlargement represents a canonical morphometric finding in chronic patients with schizophrenia; however, longitudinal studies elucidating complex dynamic trajectories of ventricular volume change during critical early disease stages are sparse. METHODS: We measured lateral ventricular volumes in 113 first-episode schizophrenia patients (FES) at baseline visit (11.7 months after illness onset, SD = 12.3) and 128 age- and sex-matched healthy controls (HC) using 3T MRI. MRI was then repeated in both FES and HC one year later. RESULTS: Compared to controls, ventricular enlargement was identified in 18.6% of patients with FES (14.1% annual ventricular volume (VV) increase; 95%CI: 5.4; 33.1). The ventricular expansion correlated with the severity of PANSS-negative symptoms at one-year follow-up (p = 0.0078). Nevertheless, 16.8% of FES showed an opposite pattern of statistically significant ventricular shrinkage during ≈ one-year follow-up (-9.5% annual VV decrease; 95%CI: -23.7; -2.4). There were no differences in sex, illness duration, age of onset, duration of untreated psychosis, body mass index, the incidence of Schneiderian symptoms, or cumulative antipsychotic dose among the patient groups exhibiting ventricular enlargement, shrinkage, or no change in VV. CONCLUSION: Both enlargement and ventricular shrinkage are equally present in the early stages of schizophrenia. The newly discovered early reduction of VV in a subgroup of patients emphasizes the need for further research to understand its mechanisms.


Asunto(s)
Imagen por Resonancia Magnética , Esquizofrenia , Humanos , Esquizofrenia/diagnóstico por imagen , Esquizofrenia/patología , Esquizofrenia/fisiopatología , Masculino , Femenino , Estudios Longitudinales , Adulto , Adulto Joven , Ventrículos Cerebrales/diagnóstico por imagen , Ventrículos Cerebrales/patología , Ventrículos Laterales/diagnóstico por imagen , Ventrículos Laterales/patología , Progresión de la Enfermedad , Estudios de Casos y Controles , Adolescente
3.
Schizophr Res ; 2023 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-37783650

RESUMEN

OBJECTIVES: To compare the prevalence, regulations, and pharmacovigilance practices of clozapine use in Eastern European countries (except Russia). METHODS: Questionnaires and data from administrative databases (2016 and 2021), package inserts and national guidelines were collected from 21 co-authors from 21 countries. Reports of clozapine adverse drug reactions (ADRs) sent to the global pharmacovigilance database (VigiBase™) were analyzed from introduction to December 31, 2022. RESULTS: Clozapine prescription among antipsychotics in 2021 varied six-fold across countries, from 2.8 % in the Czech Republic to 15.8 % in Montenegro. The utilization of antipsychotics in both 2016 and 2021 was highest in Croatia, and lowest in Serbia in 2016, and Montenegro in 2021, which had half the defined daily dose (DDD)/1000/day compared to the Croatian data. From 2016 to 2021, the prevalence of antipsychotic use increased in almost all countries; the proportion of clozapine use mainly remained unchanged. Differences were detected in hematological monitoring requirements and clozapine approved indications. Only a few national schizophrenia guidelines mention clozapine-induced myocarditis or individual titration schemes. The VigiBase search indicated major underreporting regarding clozapine and its fatal outcomes. By comparison, the United Kingdom had less than half the population of these Eastern European countries but reported to VigiBase more clozapine ADRs by 89-fold and clozapine fatal outcomes by almost 300-fold. CONCLUSION: Clozapine is under-utilized in Eastern European countries. Introducing individualized clozapine treatment schedules may help to maximize clozapine benefits and safety. Major improvement is needed in reporting clozapine ADRs and fatal outcomes in Eastern European countries.

4.
BMC Psychol ; 11(1): 34, 2023 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-36732871

RESUMEN

BACKGROUND: SuperAging is one of the current concepts related to elite, resilient or high-functioning cognitive aging. The main aim of our study was to find possible predictors of SuperAgers (SA). METHODS: Community-dwelling older persons (N = 96) aged 80-101 years in 2018 were repeatedly tested (year 2012 and 2018). SA were defined based on their performance in 2018 as persons of 80+ years of age who recalled ≥ 9 words in the delayed recall of the Philadelphia Verbal Learning Test, and had a normal performance in non-memory tasks [the Boston Naming Test, the Trail Making Test Part B, and Category Fluency ("Animals")], which was defined as a score within or above one standard deviation from the age and education appropriate average. Three composite scores (CS; immediate memory, processing speed, and executive functions) were created from the performance in 2012, and analysed as possible predictors of SA status in 2018. RESULTS: We identified 19 SA (15 females) and 77 nonSA (42 females), groups did not significantly differ in age, years of education, and sex. The logistic regression model (p = 0.028) revealed three predictors of SA from the baseline (year 2012), including processing speed (p = 0.006; CS-speed: the Prague Stroop Test-Dots and the Digit Symbol Substitution Test), sex (p = 0.015), and age (p = 0.045). CONCLUSIONS: Thus, SA may be predicted based on the level of processing speed, which supports the hypothesis of the processing speed theory of healthy aging.


Asunto(s)
Trastornos del Conocimiento , Velocidad de Procesamiento , Femenino , Humanos , Pruebas Neuropsicológicas , Trastornos del Conocimiento/psicología , Función Ejecutiva , Test de Stroop , Cognición
5.
Artículo en Inglés | MEDLINE | ID: mdl-35012440

RESUMEN

The current study aimed to define and validate the criteria for characterizing possible and probable cognitive deficits based on the psychometric approach using the Uniform data set Czech version (UDS-CZ 2.0) to reduce the rate of misdiagnosis. We computed the prevalence of low scores on the 14 subtests of UDS-CZ 2.0 in a normative sample of healthy older adults and validated criteria for possible and probable cognitive impairment on the sample of amnestic Mild Cognitive Impairment (MCI) patients. The misclassification rate of the validation sample using psychometrically derived criteria remained low: for classification as possible impairment, we found 66-76% correct classification in the clinical sample and only 2-8% false positives in the healthy control validation sample, similar results were obtained for probable cognitive impairment. Our findings offer a psychometric approach and a computational tool to minimize the misdiagnosis of mild cognitive impairment compared to traditional criteria for MCI.


Asunto(s)
Enfermedad de Alzheimer , Trastornos del Conocimiento , Disfunción Cognitiva , Humanos , Anciano , Pruebas Neuropsicológicas , Enfermedad de Alzheimer/psicología , Disfunción Cognitiva/diagnóstico
6.
Ther Adv Psychopharmacol ; 12: 20451253221136754, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36465957

RESUMEN

We report on the case of a 46-year-old woman with generalized anxiety disorder, paranoid personality disorder, and mild reduction in glomerular filtration rate (GFR). She was treated with pregabalin, trazodone, hydroxyzine, and clonazepam before hospital admission. Pharmacotherapy for the patient was changed during her first week in the hospital. Dosing of hydroxyzine and clonazepam was gradually decreased, and then these two drugs were withdrawn. Treatment with amisulpride was started on the fourth day after admission, and amisulpride serum levels were then measured three times as a part of therapeutic drug monitoring (TDM). The serum concentration of amisulpride detected during concurrent use of trazodone and pregabalin was approximately twice the therapeutic range for amisulpride. When the dose of pregabalin was reduced by half, the serum concentration of amisulpride decreased to therapeutic serum levels. We hypothesize that an interaction between amisulpride and pregabalin was responsible for the increased amisulpride concentration since both drugs are almost exclusively excreted from the body by the renal route. Pregabalin-amisulpride interaction might also be influenced by concomitant therapy with trazodone or a mild reduction in GFR. However, we only have clinical evidence for an interaction between amisulpride and pregabalin because after we halved the dose of pregabalin, the amisulpride concentration decreased, and the C/D ratio normalized. This could be helpful information for psychiatrists in order to avoid drug-drug interactions between amisulpride and pregabalin. We recommend TDM of amisulpride in patients treated concomitantly with other drugs eliminated mainly by the kidneys.

8.
Pharmacopsychiatry ; 55(2): 73-86, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34911124

RESUMEN

This international guideline proposes improving clozapine package inserts worldwide by using ancestry-based dosing and titration. Adverse drug reaction (ADR) databases suggest that clozapine is the third most toxic drug in the United States (US), and it produces four times higher worldwide pneumonia mortality than that by agranulocytosis or myocarditis. For trough steady-state clozapine serum concentrations, the therapeutic reference range is narrow, from 350 to 600 ng/mL with the potential for toxicity and ADRs as concentrations increase. Clozapine is mainly metabolized by CYP1A2 (female non-smokers, the lowest dose; male smokers, the highest dose). Poor metabolizer status through phenotypic conversion is associated with co-prescription of inhibitors (including oral contraceptives and valproate), obesity, or inflammation with C-reactive protein (CRP) elevations. The Asian population (Pakistan to Japan) or the Americas' original inhabitants have lower CYP1A2 activity and require lower clozapine doses to reach concentrations of 350 ng/mL. In the US, daily doses of 300-600 mg/day are recommended. Slow personalized titration may prevent early ADRs (including syncope, myocarditis, and pneumonia). This guideline defines six personalized titration schedules for inpatients: 1) ancestry from Asia or the original people from the Americas with lower metabolism (obesity or valproate) needing minimum therapeutic dosages of 75-150 mg/day, 2) ancestry from Asia or the original people from the Americas with average metabolism needing 175-300 mg/day, 3) European/Western Asian ancestry with lower metabolism (obesity or valproate) needing 100-200 mg/day, 4) European/Western Asian ancestry with average metabolism needing 250-400 mg/day, 5) in the US with ancestries other than from Asia or the original people from the Americas with lower clozapine metabolism (obesity or valproate) needing 150-300 mg/day, and 6) in the US with ancestries other than from Asia or the original people from the Americas with average clozapine metabolism needing 300-600 mg/day. Baseline and weekly CRP monitoring for at least four weeks is required to identify any inflammation, including inflammation secondary to clozapine rapid titration.


Asunto(s)
Antipsicóticos , Clozapina , Adulto , Antipsicóticos/efectos adversos , Pueblo Asiatico , Proteína C-Reactiva , Clozapina/efectos adversos , Femenino , Humanos , Masculino , Ácido Valproico/efectos adversos
9.
J Clin Psychopharmacol ; 41(2): 140-147, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33587398

RESUMEN

PURPOSE/BACKGROUND: A nomogram from a British naturalistic study proposed that the clozapine dosing needed to reach a serum concentration of 350 ng/mL ranged from 265 mg/d (female nonsmokers) to 525 mg/d (male smokers). Some European reviews have used these dosing recommendations, which seem greater than what we found in an Italian White sample ranging from 245 mg/d (female nonsmokers) to 299 mg/d (male smokers). Five other published samples of European Whites were added to the Italian sample to estimate clozapine doses recommended for reaching 350 ng/mL. METHODS/PROCEDURES: Average clozapine metabolizers were obtained by eliminating outliers with confounding variables: (1) psychiatric inducers and inhibitors; (2) doses less than 100 mg/d; and (3) when possible, patients with inflammation, obesity, or using oral contraceptives. The study included 1363 average metabolizer European Whites: the Italian sample and 5 new samples. Mean averages that reached serum concentration levels of 350 ng/mL were calculated after stratification by sex and smoking status in each sample. Then, weighted mean averages were obtained by combining the 6 samples. FINDINGS/RESULTS: The estimated weighted mean clozapine dosages ranged from 236 to 368 mg/d (236 mg/d in 218 female nonsmokers, 256 mg/d in 340 male nonsmokers, 357 mg/d in 269 female smokers, and 368 mg/d in 546 male smokers). IMPLICATIONS/CONCLUSIONS: Our recommended dosages are less than those recommended in Europe. Future studies in European Whites need to replicate these recommended doses for average metabolizer patients after sex and smoking stratification and further explore clozapine dosing for those with relevant clinical confounders.


Asunto(s)
Antipsicóticos/administración & dosificación , Clozapina/administración & dosificación , Fumar/epidemiología , Población Blanca , Adulto , Antipsicóticos/farmacocinética , Clozapina/farmacocinética , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Nomogramas , Factores Sexuales
10.
Front Psychiatry ; 12: 781946, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35145438

RESUMEN

Dopamine receptor partial agonists (DRPAs; aripiprazole, brexpiprazole, and cariprazine) constitute a novel class of antipsychotics. Although they share a similar mechanism of action, DRPAs differ in their pharmacodynamics, pharmacokinetics, drug interactions, or safety and tolerability. The antipsychotic efficacy of all three drugs was established in several placebo-controlled randomized trials (RCTs) in schizophrenia, both acute phase and relapse prevention. In addition, each of the DRPA agents has been tested in other psychiatric disorders, including bipolar disorder or major depression. However, a few studies have examined their comparative clinical efficacy. There are no head-to-head comparisons between aripiprazole, brexpiprazole, or cariprazine. In two acute schizophrenia RCTs of cariprazine and brexpiprazole, aripiprazole was used as an indirect comparator to control for study sensitivity. To assess potential differences in the efficacy of DRPAs, we reviewed data from controlled trials, systematic reviews, and meta-analyses. Our results showed that the acute antipsychotic effects of DRPAs, as measured by the number needed to treat, are comparable. The three agents were superior to placebo in acute treatment, and cariprazine was found to be effective in the reduction of primary negative symptoms of schizophrenia. In the therapy of bipolar disorder, aripiprazole and cariprazine showed antimanic efficacy, cariprazine was also effective in the management of bipolar depression, and aripiprazole was effective for relapse prevention. The addon administration of aripiprazole or brexpiprazole reduced symptoms of major depression. Aripiprazole can control acute agitation associated with psychosis or bipolar disorder; brexpiprazole showed the potential to manage agitation in dementia patients. Aripiprazole has also established evidence of efficacy in children and adolescents and other conditions: OCD, tic disorders, and autism spectrum disorder. Our review of published data suggests that in terms of clinical efficacy, DRPAs are a heterogeneous group, with each drug possessing its own therapeutic benefits.

11.
J Clin Exp Neuropsychol ; 43(9): 890-905, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-35125051

RESUMEN

OBJECTIVE: The Boston Naming Test (BNT) is the most widely used test to assess visual confrontation naming in both research and clinical settings. Recently, an abbreviated Czech version of the BNT was described. The purpose of this study is to assess the validity of this new test at the item level with advanced psychometric methods to assess its equivalence with the original test. The rationale was to help busy clinicians in the differential diagnosis of language disorders. METHOD: We administered the BNT-30 (odd item form of BNT-60) (N = 535; 75.61 ± 9.11; 60-96 years) and shortened the BNT-15 (N = 754; 71.94 ± 7.88; 60-96 years) to a large sample of healthy older adults. RESULTS: Significant but low associations between BNT performance and age, education, and sex were found. We found strong evidence for the unidimensionality of both BNT-15/BNT-30 versions in healthy adults (p's < .001). CONCLUSION: In-depth psychometric analysis of the BNT-15 and BNT-30 Czech versions show that test stimuli function in a similar fashion as the original BNT. Normative values adjusting for the influence of age, education, and sex are provided for use in clinical settings and future cross-cultural comparisons.


Asunto(s)
Lenguaje , Anciano , República Checa , Humanos , Pruebas del Lenguaje , Pruebas Neuropsicológicas , Psicometría
12.
Clin Neuropsychol ; 35(8): 1381-1397, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-32306891

RESUMEN

OBJECTIVE: The purpose of the present study was to investigate if participants in NANOK study (National Normative Study of Cognitive Determinants of Healthy Ageing) who show no cognitive decline throughout five years (successful healthy agers; SHA) will show less age-related differences in instrumental activities of daily living (IADL) based on Functional Activities Questionnaire in comparison to participants who show subtle cognitive decline (Decliners) over time. METHOD: We used two different classifications of SHA: Rogalski (N = 25 SHA and N = 15 Decliners) based on cross-sectional neuropsychology measures and linear mixed model (LMEM; 20 SHA and 20 Decliners) based on the Montreal Cognitive Assessment longitudinal 5-years follow-up. Whole-brain T1- and T2-weighted images were corrected for distortions and segmented using Freesurfer. Whole-brain volumetry was performed using FSL's voxel-based morphometry tool. RESULTS: The cognitive decline after four years follow-up but not age predicts subtle impairment in IADL in healthy ageing participants. We found brain volumetric differences between SHA and Decliners based on Rogalski but not LMEM classification especially in bilateral insular cortices and ventrolateral frontal cortex. The logistic regression model achieved an accuracy of 75% for the Rogalski in comparison to 67.5% for the LMEM classification. CONCLUSIONS: Slight restrictions in IADL seem to be a useful tool for screening healthy ageing participants at risk of developing subtle cognitive decline over a period of five years and the cross-sectional Rogalski criteria based on standardized neuropsychological measures were superior for tapping age-related brain changes to longitudinal LMEM classification based on screening (Montreal Cognitive Assessment).


Asunto(s)
Disfunción Cognitiva , Envejecimiento Saludable , Actividades Cotidianas , Cognición , Disfunción Cognitiva/diagnóstico , Estudios Transversales , Humanos , Pruebas Neuropsicológicas
13.
J Clin Exp Neuropsychol ; 42(10): 1099-1110, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33198558

RESUMEN

Introduction: The Brief Visual Memory Test-Revised (BVMT-R) is a frequently used visuospatial declarative memory test, but normative data in the Czech population are lacking. Moreover, the BVMT-R includes promising learning indexes that can be used to detect learning deficits in Parkinson's disease (PD). However, its clinical usefulness has not yet been thoroughly examined. Early detection of memory impairment in PD is essential for effective treatment. Therefore, this study aimed to provide BVMT-R Czech normative data for clinical use and to find the detection potential of the principal BVMT-R scores, including new learning indices, to capture the cognitive deficit in PD. Method: The BVMT-R were administered to a normative sample of 920 participants aged 17 to 95 years and to a clinical sample of 60 PD patients; 25 with mild cognitive impairment (PD-MCI) and 35 with normal cognition (PD-NC). In order to provide normative values, multiple regression analyses were employed, and to compare the clinical and control sample, Bayesian Hierarchical Linear Models were used. Results: The best model for regression-based norms showed to be with age + age2 + education + sex as predictors. From all learning indexes, L6 (sum of trials 1-3), followed by, L4 (sum of trials 1-3 multiplied by the difference between the highest and the lowest score) best differentiated between controls or PD-NC and PD-MCI. Conclusions: We provide regression-based normative values for BVMT-R that could be used in clinical settings and meta-analytic efforts. Furthermore, we revealed visuospatial learning and memory deficit in PD-MCI. We have also identified the most discriminative learning index adapted to BVMT-R.


Asunto(s)
Disfunción Cognitiva/fisiopatología , Aprendizaje/fisiología , Trastornos de la Memoria/fisiopatología , Pruebas Neuropsicológicas/normas , Enfermedad de Parkinson/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/etiología , Femenino , Humanos , Masculino , Trastornos de la Memoria/etiología , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Adulto Joven
14.
Cas Lek Cesk ; 159(7-8): 312-316, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33445938

RESUMEN

Vitamin D supplementation reduced the risk of acute respiratory tract infection in two meta-analyses. Mendelian randomization shows a causal effect of low vitamin D on bacterial pneumonias risk. These studies involved patients before COVID-19 pandemic. Several association studies found higher incidence of SARS-CoV-2 positivity, greater COVID-19 severity and higher risk of mortality in vitamin D deficient subjects compared to vitamin D non-deficient controls. We draw attention to the trend of inverse relative COVID-19 mortality in Europe versus the states of the Southern Hemisphere (Australia, Brazil, South Africa) in dependence on season, which may be associated with intensity of ultraviolet radiation and consequent seasonal fluctuation of serum vitamin D levels. Although we cannot yet confirm causal role of vitamin D in SARS-CoV-2 positivity or COVID-19, we recommend consumption of vitamin D rich food or vitamin D supplementation in the non-sunny season to prevent vitamin D deficiency.


Asunto(s)
COVID-19 , Vitamina D , Europa (Continente) , Humanos , Pandemias , SARS-CoV-2 , Estaciones del Año , Rayos Ultravioleta
15.
Assessment ; 27(8): 1960-1970, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-29929376

RESUMEN

The Montreal Cognitive Assessment (MoCA) is one of the most common screening instruments for mild cognitive impairment. However, the standard MoCA is approximately two times longer to administer than the Mini-Mental State Examination. A total of 699 Czech and 175 American participants received the standard MoCA Czech and English versions and in the clinical part, a sample of 102 nondemented patients with Parkinson's disease (PD). We created a validated Czech short version (s-MoCA-CZ) from the original using item response theory. As expected, s-MoCA-CZ scores were highly correlated with the standard version (Pearson r = .94, p < .001). s-MoCA-CZ also had 80% classification accuracy in the differentiation of PD mild cognitive impairment from PD without impairment. The s-MoCA-CZ, a brief screening tool, is shorter to administer than the standard MoCA. It provides high-classification accuracy for PD mild cognitive impairment and is equivalent to that of the standard MoCA-CZ.


Asunto(s)
Disfunción Cognitiva , Enfermedad de Parkinson , Cognición , Disfunción Cognitiva/diagnóstico , Comparación Transcultural , República Checa , Humanos , Pruebas de Estado Mental y Demencia , Pruebas Neuropsicológicas , Enfermedad de Parkinson/diagnóstico
16.
Psych J ; 9(1): 147-149, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31721477

RESUMEN

Some people aged 80 years and older are "memory SuperAgers" (SAs), that is, they have the episodic memory of a sexagenarian. In a sample of 208 non-demented adults, we found that 12% were SAs. A total of 101 participants completed the 4-year study; of this subsample, 10.9% were stable SAs and 61.3% stable non-SAs across all assessments. The SA phenotype is conducive to further research.


Asunto(s)
Envejecimiento , Cognición , Voluntarios Sanos/estadística & datos numéricos , Memoria Episódica , Pruebas Neuropsicológicas/estadística & datos numéricos , Anciano de 80 o más Años , Femenino , Humanos , Masculino
17.
Neuro Endocrinol Lett ; 40(2): 75-78, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31785213

RESUMEN

OBJECTIVES: Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). METHODS: We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D deficiency on BMI. RESULTS: The BMI was significantly higher after long-term MARTA exposure in 25(OH)D-deficient patients than in non-deficient patients. No significant difference was found in antipsychotic exposure between the long-term MARTA exposure groups. The BMI was significantly higher in long-term MARTA exposure 25(OH)D-deficient patients than in 25(OH)D-deficient patients without long-term exposure. CONCLUSION: Vitamin D deficiency could be a risk factor for MARTA-induced weight gain. Further studies are necessary to replicate this finding.


Asunto(s)
Antipsicóticos/uso terapéutico , Índice de Masa Corporal , Esquizofrenia/tratamiento farmacológico , Esquizofrenia/epidemiología , Deficiencia de Vitamina D/epidemiología , Adulto , Antipsicóticos/clasificación , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Esquizofrenia/sangre , Esquizofrenia/complicaciones , Vitamina D/análogos & derivados , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Adulto Joven
18.
J Alzheimers Dis ; 72(3): 693-701, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31609688

RESUMEN

BACKGROUND: Studies from North America and Western Europe suggest stable or declining trends in impaired cognition across birth cohorts. OBJECTIVE: We aimed to examine changes in the age-specific prevalence of cognitive impairment in the Czech Republic. METHODS: The study used two samples from the population-based Czech Survey on Health, Ageing and Retirement in Europe. Age-specific prevalence of cognitive impairment (defined based on scores in verbal fluency, immediate recall, delayed recall, and temporal orientation) was compared between participants in wave 2 (2006/2007; n = 1,107) and wave 6 (2015; n = 3,104). Logistic regression was used to estimate the association between the wave and cognitive impairment, step-wise adjusting for sociodemographic and clinical characteristics. Multiple sensitivity analyses, focusing on alternative operationalizations of relative cognitive impairment, impact of missing cognitive data, and survival bias, were carried out. RESULTS: The most conservative estimate suggested that the age-specific prevalence of cognitive impairment declined by one fifth, from 11% in 2006/2007 to 9% in 2015. Decline was observed in all sensitivity analyses. The change was associated with differences in physical inactivity, management of high blood cholesterol, and increases in length education. CONCLUSION: Older adults in the Czech Republic, a country situated in the Central and Eastern European region, have achieved positive developments in cognitive aging. Longer education, better management of cardiovascular factors, and reduced physical inactivity seem to be of key importance.


Asunto(s)
Envejecimiento/psicología , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/psicología , Encuestas Epidemiológicas/tendencias , Anciano , Anciano de 80 o más Años , Envejecimiento/patología , Disfunción Cognitiva/diagnóstico , República Checa/epidemiología , Femenino , Humanos , Vida Independiente/tendencias , Estudios Longitudinales , Masculino , Estudios Prospectivos
19.
Biol Psychiatry ; 86(7): 545-556, 2019 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-31443932

RESUMEN

BACKGROUND: Schizophrenia and bipolar disorder share genetic liability, and some structural brain abnormalities are common to both conditions. First-degree relatives of patients with schizophrenia (FDRs-SZ) show similar brain abnormalities to patients, albeit with smaller effect sizes. Imaging findings in first-degree relatives of patients with bipolar disorder (FDRs-BD) have been inconsistent in the past, but recent studies report regionally greater volumes compared with control subjects. METHODS: We performed a meta-analysis of global and subcortical brain measures of 6008 individuals (1228 FDRs-SZ, 852 FDRs-BD, 2246 control subjects, 1016 patients with schizophrenia, 666 patients with bipolar disorder) from 34 schizophrenia and/or bipolar disorder family cohorts with standardized methods. Analyses were repeated with a correction for intracranial volume (ICV) and for the presence of any psychopathology in the relatives and control subjects. RESULTS: FDRs-BD had significantly larger ICV (d = +0.16, q < .05 corrected), whereas FDRs-SZ showed smaller thalamic volumes than control subjects (d = -0.12, q < .05 corrected). ICV explained the enlargements in the brain measures in FDRs-BD. In FDRs-SZ, after correction for ICV, total brain, cortical gray matter, cerebral white matter, cerebellar gray and white matter, and thalamus volumes were significantly smaller; the cortex was thinner (d < -0.09, q < .05 corrected); and third ventricle was larger (d = +0.15, q < .05 corrected). The findings were not explained by psychopathology in the relatives or control subjects. CONCLUSIONS: Despite shared genetic liability, FDRs-SZ and FDRs-BD show a differential pattern of structural brain abnormalities, specifically a divergent effect in ICV. This may imply that the neurodevelopmental trajectories leading to brain anomalies in schizophrenia or bipolar disorder are distinct.


Asunto(s)
Trastorno Bipolar , Encéfalo/patología , Predisposición Genética a la Enfermedad , Esquizofrenia , Adulto , Trastorno Bipolar/genética , Trastorno Bipolar/patología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/genética , Esquizofrenia/patología , Adulto Joven
20.
J Alzheimers Dis ; 70(1): 61-73, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31177209

RESUMEN

BACKGROUND: Subjective cognitive complaints (SCCs) may represent an early cognitive marker of Alzheimer's disease (AD). There is a need to identify specific SCCs associated with an increased likelihood of underlying AD. OBJECTIVE: Using the Questionnaire of Cognitive Complaints (QPC), we evaluated the pattern of SCCs in a clinical sample of non-demented older adults in comparison to cognitively healthy community-dwelling volunteers (HV). METHODS: In total, 142 non-demented older adults from the Czech Brain Aging Study referred to two memory clinics for their SCCs were classified as having subjective cognitive decline (SCD, n = 85) or amnestic mild cognitive impairment (aMCI, n = 57) based on a neuropsychological evaluation. Furthermore, 82 age-, education-, and gender-matched HV were recruited. All subjects completed the QPC assessing the presence of specific SCCs in the last six months. RESULTS: Both SCD and aMCI groups reported almost two times more SCCs than HV, but they did not differ from each other in the total QPC score. Impression of memory change and Impression of worse memory in comparison to peers were significantly more prevalent in both SCD and aMCI groups in comparison to HV; however, only the latter one was associated with lower cognitive performance. CONCLUSION: The pattern of QPC-SCCs reported by SCD individuals was more similar to aMCI individuals than to HV. A complaint about memory change seems unspecific to pathological aging whereas a complaint about worse memory in comparison to peers might be one of the promising items from QPC questionnaire potentially reflecting subtle cognitive changes.


Asunto(s)
Envejecimiento/psicología , Cognición/fisiología , Disfunción Cognitiva/psicología , Trastornos de la Memoria/psicología , Memoria/fisiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Encuestas y Cuestionarios
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