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1.
Rev. SPAGESP ; 21(2): 83-96, jul.-dez. 2020. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1125733

RESUMO

Este estudo descritivo exploratório investigou a prevalência de Prática de Atividades Prazerosas (PAP), bem-estar Subjetivo (BES), Depressão e Solidão em 59 idosos provenientes de grupos de convivência. Foram aplicados: Questionário Sociodemográfico, Escal a de Atividades Instrumentais da Vida Diária de Pfeffer, Escala de Afetos Negativos e Positivos, Escala de Satisfação com a Vida, Escala de Depressão Geriátrica - versão reduzida, Escala Brasileira de Solidão e OPPES-BR. Os idosos da amostra eram majoritar iamente mulheres, jovens idosos, viúvos, escolarizados, com bom estado funcional e que avaliavam sua saúde de forma positiva. A amostra apresentou médias altas para PAP e BES e médias baixas para solidão e depressão. Grupos de convivência favorecem a saúde mental de idosos e contribuem para o envelhecimento bem-sucedido, uma vez que esses espaços fornecem oportunidades de suporte social, engajamento em atividades prazerosas e experiência de sentimentos positivos.


This descriptive and exploratory study investigated the prevalence of Involvement in Pleasant Events, Subjective Well-Being, Depression, and Loneliness in 59 elderly from social groups without apparent cognitive impairment. A sociodemographic questionnaire, the Pfeffer Index, the Negative and Positive Affect Scale, the Life Satisfaction Scale, the Geriatric Depression Scale - reduced version, the Brazilian Loneliness Scale, and OPPES-BR were applied. The elderly were mostly women, young, widowed, educated, with a good functional state, and with a positive health evaluation. Participants showed high levels of Involvement in Pleasant Events and Subjective Well Being, and low levels of loneliness and depression. Social groups provide opportunities for social support, engagement in pleasant events, positive emotions and may contribute to the elderly's mental health and successful aging.


Este estudio exploratorio descriptivo investigó la prevalencia de la práctica de actividad placentera (PAP), el bienestar subjetivo (BES), la depresión y la soledad en 59 personas mayores proveniente de grupos sociales. Se aplicaron el Cuestionario sociodemográfico, la Escala de actividades instrumentales de la vida diaria de Pfeffer, la Escala de afectos negativos y positivos, la Escala de satisfacción con la vida, la Escala de depresión geriátrica - versión reducida, la Escala de soledad brasileña y OPPES-BR. Los ancianos de la muestra eran en su mayoría mujeres, ancianos más jóvenes, viudos, escolarizados, con buen estado funcional y que evaluaron positivamente su salud. En general, los ancianos tenían altas tasas de PAP y BES y bajas tasas de soledad y depresión. Los grupos sociales favorecen la salud mental de las personas mayores y contribuyen al envejecimiento exitoso, ya que estos espacios traen oportunidades de apoyo social, participación en actividades placenteras y experiencia de sentimientos positivos.


Assuntos
Humanos , Masculino , Feminino , Idoso , Satisfação Pessoal , Apoio Social , Avaliação em Saúde , Envelhecimento , Indicadores Básicos de Saúde , Viuvez , Afeto , Depressão , Disfunção Cognitiva , Promoção da Saúde , Atividades de Lazer , Solidão
2.
Rev. enferm. UERJ ; 28: e49370, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1122754

RESUMO

Objetivos: descrever a média total de independência geral e por domínios de comunicação dos idosos da comunidade e verificar as variáveis sociodemográficas e de saúde associadas à maior média de independência de comunicação entre os idosos. Métodos: estudo transversal e analítico, desenvolvido entre 808 idosos da comunidade. Procederam-se às análises: descritiva, bivariada e regressão linear múltipla (p<0,05). Resultados: verificou-se necessidade mínima de auxílio na comunicação (6,43±0,77); quanto aos domínios obteve maior escore de independência de comunicação nas necessidades básicas (6,88±0,51) e menor na leitura, escrita e conceitos numéricos (5,96±1,63). A maior média de independência de comunicação associou-se à faixa etária 60├80 (p<0,001); ter escolaridade (p<0,001); renda maior que um salário mínimo (p<0,001); à ausência do declínio cognitivo (p<0,001) e do indicativo de sintomas depressivos (p=0,014). Conclusão: a escolaridade, menor idade, maior renda e a ausência do declínio cognitivo e do indicativo de sintomas depressivos contribuíram para maior independência de comunicação.


Objectives: to describe the total mean of independence and communication domains of the elderly in the community, and to verify the sociodemographic and health variables associated with the highest mean of independence of communication among the elderly. Methods: A cross - sectional and analytical study developed among 808 elderly people in the community. The analyzis were: descriptive, bivariate and linearly multiple regression (p<0.05). Results: There was a minimum need for assistance in communication (6.43 ± 0.77); concerning the domains, it obtained a higher score of communication independence in basic needs (6.88 ± 0.51) and lower in reading, writing and numerical concepts (5.96 ± 1.63). The highest average of communication independence was associated with the age group 60├80 (p<0.001); having schooling (p<0.001); income greater than a minimum wage (p<0.001); the absence of cognitive decline (p<0.001) and indicative of depressive symptoms (p=0.014). Conclusion: Schooling, lower age, higher income and the absence of cognitive decline and indicative of depressive symptoms contributed to greater communication independence.


Objetivos: describir el promedio general de independencia y los ámbitos de comunicación de los ancianos de la comunidad y verificar las variables sociodemográficas y de salud asociadas a la mayor media de independencia de comunicación entre los ancianos. Métodos: Estudio transversal y analítico, desarrollado entre 808 ancianos de la comunidad. Se realizaron los análisis: descriptiva, bivariada y regresión linealmente dolara (p<0,05). Resultados: Se verificó la mínima ayuda de comunicación (6,43 ± 0,77); En cuanto a los dominios, una puntuación más alta de independencia de comunicación en necesidades básicas (6,88 ± 0,51) y menor en lectura, escritura y conceptos numéricos (5,96 ± 1,63). Un promedio mayor de independencia de comunicación se asoció a la franja etaria 60├80 (p<0,001); tener escolaridad (p<0,001); el ingreso mayor que un salario mínimo (p<0,001); la ausencia del cognitivo (p<0,001) y del indicativo de síntomas depresivos (p=0,014). Conclusión: La escolaridad, menor edad, menor renta y la ausencia del cognitivo y del indicador de síntomas depresivos contribuyeron a una mayor independencia de comunicación.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Saúde do Idoso , Comunicação , Brasil , Atividades Cotidianas , Demografia , Estudos Transversais , Depressão , Escolaridade , Disfunção Cognitiva , Renda , Cuidados de Enfermagem
3.
Zhonghua Yi Xue Za Zhi ; 100(41): 3224-3229, 2020 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-33167108

RESUMO

Objective: To evaluate the value of intraoperative cerebral oxygen saturation in predicting postoperative neurocognitive dysfunction (PND) in elderly patients with mild cognitive impairment. Methods: A total of 210 cases of lumbar decompression, bone grafting and fusion surgery under general anesthesia were collected in the Third Central Hospital of Tianjin from June, 2019 to January, 2020, either sex, aged 65-75 year, BMI 19.5-32.5 kg/m(2), ASA physical status Ⅱ or Ⅲ, preoperative comorbidities with mild cognitive impairment. MoCA and MMSE were used to evaluate the cognitive function of patients 1 day before the operation, 7 days and 3 monthes after operation. PND group (n=38) and non-PND group (n=172) were selected according to postoperative MMSE and MoCA scale scores and the diagnostic criteria of PND. Heart rate (HR) , mean arterial pressure (MAP), pulse oxygen saturation (SpO(2)), bispectral index (BIS), cerebral tissue oxygen saturation (SctO(2), average left and right brain SctO(2) were recorded) were recorded pre-anesthetic (T(0)), ten minutes of anesthesia(T(1)), twenty minutes of anesthesia (T(2)), thirty minutes into the operation (T(3)), one hour into the operation (T(4)), end of the surgery (T(5)), and leave the PACU (T(6)). SctO(2) at time point T(0) was the base value of SctO(2), and the maximum percentage drop in SctO(2) from the base value was calculated (SctO(2max)%). Results: The incidence of PND was 18% (38/210) in 210 elderly patients undergoing surgery. The age of PND group and non-PND group was (71.0±2.1) and (67.8±2.0) years old, and the PACU time was (57±5) and (46±8) min, respectively. Compared with the non-PND group, the age of the PND group was higher (t=2.600, P<0.05) and the PACU time was longer (t=3.039, P<0.05). At the time points T(3), T(4), T(5) and T(6), SctO(2) in the PND group was (62±10) %, (60±11) %, (64±12) % and (66±10)%, respectively, lower than that in the non-PND group (67±60) %, (68±6) %, (69±5) % and (70±7)%, respectively, and the difference was statistically significant (t=3.369, 4.906, 3.787, 2.516, all P<0.05).The MoCA and MMSE scores of the PND group were (22.9±1.2) and (24.1±1.2) points, respectively, 1 day before surgery; and the MoCA and MMSE scores of the PND group were reduced to (20.8±1.2) and (21.3±0.7) points, respectively, 7 days after surgery, with statistically significant differences (t=3.523, 5.675, all P<0.05). MoCA and MMSE scores 7 days after surgery in the non-PND group were (22.4±1.3) and (23.1±1.6) points, respectively. Compared with the non-PND group, MoCA and MMSE scores 7 days after surgery in the PND group were reduced (t=2.630, 3.108, all P<0.05). The critical value of intraoperative SctO(2max)% was 13.74%, the area under the curve of PND was predicted to be 0.907 (95%CI: 0.819-0.995), sensitivity and specificity were 88.9% and 88.5%, respectively. Conclusion: SctO(2max)%>13.74% can be used as an indicator to predict PND occurrence in elderly patients with mild cognitive impairment during lumbar surgery.


Assuntos
Disfunção Cognitiva , Idoso , Anestesia Geral , Cognição , Disfunção Cognitiva/etiologia , Humanos , Oxigênio , Troca Gasosa Pulmonar
4.
Zhongguo Zhong Yao Za Zhi ; 45(19): 4766-4775, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33164444

RESUMO

Tianzhi Granules has effects in calming liver wind, nourishing liver and kidney and activating blood. At present, it is used for treatment of vascular cognitive impairment. However, its efficacy and safety remained to be verified. Therefore, this study aims to systematically analyze the efficacy and safety of Tianzhi Granules in the treatment of vascular cognitive impairment. CNKI, VIP, WanFang, SinoMed, PubMed and Cochrane Library, ClinicalTrials.gov were retrieved to screen out relevant randomized controlled trials about the effect of Tianzhi Granules on vascular cognitive impairment according to the inclusion criteria. Two researchers independently used the risk of bias assessment tool for quality assessment, and extracted and checked the data. Cochrane systematic evaluation software RevMan 5.3 was used for data analysis. Twenty-seven articles involving 2 741 subjects were included. The intervention measure was Tianzhi Granules alone, and the control measure was Western medicine alone or blank control. According to the results, Tianzhi Granules was better than blank control and brain metabolism promoter in clinical efficacy rate and improvement of MMSE score. And it was better than blank control and nimodipine in the improvement of event-related potential(ERP) P300. Within 3 months, Tianzhi Granules had better effects than Western medicine group and blank group, with a low incidence of adverse events. Tianzhi Granules can be recommended for clinical use. However, due to the low quality of the include literatures, these potential benefits need to be confirmed in future standardized clinical trials with a large sample size.


Assuntos
Disfunção Cognitiva , Medicamentos de Ervas Chinesas , Disfunção Cognitiva/tratamento farmacológico , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Resultado do Tratamento
5.
J Korean Med Sci ; 35(42): e383, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33140593

RESUMO

Multiple neurological complications have been associated with the coronavirus disease-19 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2. This is a narrative review to gather information on all aspects of COVID-19 in elderly patients with cognitive impairment. First, the following three mechanisms have been proposed to underlie the neurological complications associated with COVID-19: 1) direct invasion, 2) immune and inflammatory reaction, and 3) hypoxic brain damage by COVID-19. Next, because the elderly dementia patient population is particularly vulnerable to COVID-19, we discussed risk factors and difficulties associated with cognitive disorders in this vulnerable population. We also reviewed the effects of the patient living environment in COVID-19 cases that required intensive care unit (ICU) care. Furthermore, we analyzed the impact of stringent social restrictions and COVID-19 pandemic-mediated policies on dementia patients and care providers. Finally, we provided the following strategies for working with elderly dementia patients: general preventive methods; dementia care at home and nursing facilities according to the activities of daily living and dementia characteristics; ICU care after COVID-19 infection; and public health care system and government response. We propose that longitudinal follow-up studies are needed to fully examine COVID-19 associated neurological complications, such as dementia, and the efficacy of telemedicine/telehealth care programs.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Demência/epidemiologia , Serviços de Saúde para Idosos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Atividades Cotidianas , Idoso , Betacoronavirus , Encéfalo/fisiopatologia , Cuidadores , Disfunção Cognitiva/complicações , Disfunção Cognitiva/epidemiologia , Infecções por Coronavirus/complicações , Cuidados Críticos , Demência/complicações , Humanos , Hipóxia , Sistema Imunitário , Inflamação , Casas de Saúde , Pneumonia Viral/complicações , Medicina Preventiva , Saúde Pública , Fatores de Risco , Isolamento Social , Telemedicina
7.
Australas J Ageing ; 39(3): 283-286, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33051999

RESUMO

OBJECTIVE: We developed interim guidance for the care of patients with cognitive impairment in hospital during the COVID-19 pandemic. METHODS: A Guidance Committee and Readers Group were recruited. The content was identified by the Committee and content-specific subgroups, resulting in a draft document, which was sent to the Readers for review. People with dementia and care partners were involved in all aspects of the process. RESULTS: Infection control measures can lead to an escalation of distress. In an environment where visiting bans are applied to care partners/advocates, hospitals need to ensure care partners can continue to provide decision-making support. Health-care professionals can proactively engage care partners using videoconferencing technologies. Developing models of care that proactively support best practice can minimise the risk of delirium, mitigate escalating symptoms and guide the use of non-pharmacological, pharmacological (start low, go slow) or physical restraint in managing behavioural and psychological symptoms.


Assuntos
Betacoronavirus , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Adulto , Austrália , Infecções por Coronavirus/transmissão , Hospitalização , Humanos , Pneumonia Viral/transmissão
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 256-259, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33017977

RESUMO

In recent years, electroencephalography (EEG) has emerged as a low-cost, accessible and objective tools for the early diagnosis of Alzheimer's disease (AD). AD is preceded by Mild Cognitive Impairment (MCI), typically refers to early-stage AD disease. The purpose of this study is to classify MCI patients from the multi-domain features of their electroencephalography (EEG). Firstly, we extracted the multi-domain (time, frequency and information theory) features from resting-state EEG signals before and after a cognitive task from 15 MCI groups and 15 age-matched healthy controls. Then, principal component analysis (PCA) was used to perform feature selection. After that, we compared the performance between SVM and KNN on our EEG dataset. The good performance was observed both from SVM and KNN, which demonstrates the effectiveness of multi-domain features. Furthermore, KNN performs better than SVM and the EEG signals after the cognitive task works better than those before the task.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/diagnóstico , Disfunção Cognitiva/diagnóstico , Eletroencefalografia , Humanos
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1084-1087, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018174

RESUMO

Recently, more evidences manifest that the subjective cognitive decline (SCD) of unimpaired individual may represent first symptom of Alzheimer's disease (AD). This study investigated the differences of intrinsic glucose metabolic functional connectivity between SCD and healthy subject (HC) groups from the perspective of brain network topology. In this study we attained 18F-Fluorodeoxyglucose positron emission tomography (18F-FDG PET) scans from Xuanwu Hospital, Beijing, China, including 85 SCD subjects (male = 16, mean age = 66, MMSE = 28.4) and 74 HC subjects (male = 37, mean age = 65,MMSE=29.0). Graph theory method has been used in this study. Network parameters, including global efficiency, local efficiency, characteristic path length, clustering coefficient, betweenness centrality, sigma and modularity were calculated and compared between two groups. As a result, both SCD and HC groups showed the small-world property. Meanwhile, SCD showed loss of small-world properties, for example, sigma in SCD was significantly lower than HC (p<0.05). In addition, the clustering coefficient and local efficiency of SCD were both higher than HC significantly (p<0.05). In contrast, the characteristic path length and global efficiency of SCD were lower than HC, which led to the regularization of brain network in SCD group. Furthermore, we found global modularity of SCD was lower than HC and the number of modules also decreased. Our findings suggested that there exist differences in glucose metabolic brain network between two groups, demonstrating that the graph theory analysis method could be useful and helpful to predict risks in the preclinical stage of AD.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Encéfalo/diagnóstico por imagem , China , Glucose , Humanos
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1096-1099, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018177

RESUMO

Simultaneously resting brain glucose metabolism and intrinsic functional activity, by integrated PET/MRI scans, both reflect nerve actions. Studies showed that there existed relevance between two phenotypes of neuros in normal human brains. However, whether the relevance will change in cognitive dysfunction (CD) brains is still unknown. The aim of this study therefore is to explore the relevance between voxel-wise glucose metabolism and functional connectivity in Chinese CD people. The dataset in this study included two imaging modalities and clinical information of 21 healthy control (HC) individuals and 15 CD patients, from Xuanwu hospital, Beijing, China. Firstly, we calculated the standardized uptake value rate (SUVR) from positron emission tomography (PET), and three parameters for intrinsic functional activity from functional magnetic resonance imaging (fMRI), including amplitude of low frequency fluctuations (ALFF), fractional amplitude of low frequency fluctuations (fALFF) and regional homogeneity (ReHo). Second, the two sample t-test was used to compare each parameter between HC and CD groups respectively. Third, the relevance between SUVR and the three fMRI parameters were measured by Spearman's rank correlation. The results of t-test showed that glucose metabolism consumption decreased in Default Mode Network (DMN) (p < 0.01), and the damage of functional connection also happened DMN area in CD group. The correlation between glucose metabolism and functional activity in CD group was lower than that in HC group in DMN. Especially, the correlation between SUVR and ReHo was significantly reduced (p < 0.05). Above results promoted a deeper understanding on the pathogenesis of cognitive impairment, and providing new biomarkers to discriminate CD and HC subjects.


Assuntos
Disfunção Cognitiva , Tomografia por Emissão de Pósitrons , Encéfalo/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Glucose , Humanos , Imagem por Ressonância Magnética
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1762-1765, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018339

RESUMO

Subjective cognitive decline (SCD) is a high-risk preclinical stage in the progress of Alzheimer's disease (AD). Its timely diagnosis is of great significance for older adults. Though multi-parameter magnetic resonance imaging (MPMRI) is a noninvasive neuroimaging technique to detect SCD, the lack of biomarkers and computed aided diagnosis (CAD) tools is a major concern for its application. Radiomics, a high-dimensional imaging feature extraction method, has been widely used for identifying biomarkers and developing CAD tools in oncological studies. Therefore, in this study, we aimed to investigate whether the radiomic approach could be used for the diagnosis of SCD. In the proposed radiomic approach, we mainly performed four steps: image preprocessing, feature extraction and screening, and classification. The dataset from Xuanwu Hospital, Beijing, China, was used in this study, including 105 healthy controls (HC) and 130 SCD subjects. All subjects were divided into one training & validation group and one test group. We extracted 30128 radiomic features from MPMRI of each subject. The t-test, autocorrelation, and Fisher score were performed for feature selection, and we deployed the support vector machine (SVM) for classification. The above process was performed 100 times with 5-fold cross-validation. The results showed that the accuracy, sensitivity, and specificity of classification was 89.03%±5.37%, 85.44%±9.28% and 91.97%±6.38% in the validation set and 84.70%±4.68%, 86.98%±10.49% and 82.59%±7.07% in the test set. In conclusion, this study has shown that the radiomic approach could be used to discriminate SCD and HC with high accuracy and sensitivity effectively.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Idoso , Doença de Alzheimer/diagnóstico , China , Disfunção Cognitiva/diagnóstico , Humanos , Imagem por Ressonância Magnética , Máquina de Vetores de Suporte
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1775-1778, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018342

RESUMO

Subjective cognitive decline (SCD) is the preclinical stage of Alzheimer's disease (AD). Abnormal brain glucose metabolism and Aß depositions can be observed in SCD subjects. Nevertheless, there was not cognitive impaired performance in standardized neuropsychological in these subjects. Cognitive reserve (CR) could be the reason to explain this phenomenon. However, correspondence between CR and SCD was still uncleared. In this study, we attained 74 subjects underwent 18FFDG PET scans (SCD1 group) and 38 patients underwent 18FAV45 PET scans (SCD2 group) from Xuanwu Hospital, Beijing, China. First, SCD1 group was divided into SCD1H (high CR, n=33, educational years>12) and SCD1L (low CR, n=41, educational years<=12) groups. The SCD2 group was divided into SCD2H (high CR, n=17, educational years>12) and SCD2L (low CR, n=21, educational years<=12) groups. Second, we calculated standardized uptake value rate (SUVR) values of 18FFDG PET and 18F-AV45 PET images in voxel-wise level. Third, the two-sample t-test between low and high CR groups was used to investigate the effects of CR. As a result, the SUVR values of FDG-PET images in SCD1H (0.89±0.11) were significant lower than SCD1L (0.96±0.13, p=0.017). The SUVR values of AV45PET images in SCD2H (0.63±0.11) were significant lower than SCD2L (0.78±0.15, p=0.001). In addition, the frontal lobe was found as the main area of hypometabolism and reduced AB depositions. As a conclusion, there are differential glucose metabolism and Aß deposition patterns in SCD subjects between low and high CR groups.


Assuntos
Disfunção Cognitiva , Reserva Cognitiva , Encéfalo/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Glucose , Humanos
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2088-2091, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018417

RESUMO

A relationship between ultrasound strain indices in carotid plaque to cognitive domains of executive and language function are studied in 42 symptomatic and 34 asymptomatic patients. The mean and standard deviation of the percentage stenosis were 72.10 ± 15.19 and 77.41 ± 11.20 for symptomatic and asymptomatic patients respectively. Pearson's correlation between axial, lateral and shear strain indices versus executive and language composite scores was performed.. A significant inverse correlation for both executive and language function for symptomatic patients to strain indices was found. On the other hand, for asymptomatic patients only executive function was inversely correlated with the corresponding strain indices. Our hypothesis that microemboli from vulnerable plaque and possible 'silent strokes' may be responsible for decline in executive function for both symptomatic and asymptomatic patients'. Strokes and transient ischemic attacks may be responsible for further cognitive decline in language function for symptomatic patients.


Assuntos
Estenose das Carótidas , Disfunção Cognitiva , Placa Aterosclerótica , Estenose das Carótidas/diagnóstico por imagem , Humanos , Placa Amiloide , Placa Aterosclerótica/diagnóstico por imagem , Ultrassonografia
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3204-3207, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018686

RESUMO

Alzheimer's disease (AD) affects approximately 30 million people worldwide, and this number is predicted to triple by 2050 unless further discoveries facilitate the early detection and prevention of the disease. Computerized walkways for simultaneous assessment of motor-cognitive performance, known as a dual-task assessment, has been used to associate changes in gait characteristics to mild cognitive impairment (MCI) with early-stage disease. However, to our best knowledge, there is no validated method to detect MCI using the collective analysis of these gait characteristics. In this paper, we develop a machine learning approach to analyze the gait data from the dual-task assessment in order to detect subjects with cognitive impairment from healthy individuals. We collected dual-task gait data from a computerized walkway of a total of 92 subjects with 31 healthy control (HC) and 61 MCI. Using support vector machine (SVM) and gradient tree boosting, we developed a classifier to differentiate MCI from HC subjects and compared the results with a paper-based questionnaire assessment that has been commonly used in clinical practice. SVM provided the highest accuracy of 77.17% with 81.97% sensitivity and 67.74% specificity. Our results indicate the potential of machine learning + dual-task assessment to enable early diagnosis of cognitive decline before it advances to dementia and AD, so that early intervention or prevention strategies can be initiated.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/diagnóstico , Disfunção Cognitiva/diagnóstico , Diagnóstico Precoce , Marcha , Humanos , Aprendizado de Máquina
15.
Artigo em Russo | MEDLINE | ID: mdl-33081441

RESUMO

OBJECTIVE: To study the relationship between cognitive deficits and retinal neuroarchitectonics in Alzheimer's disease, vascular dementia, and glaucoma based on optical coherence tomography. MATERIAL AND METHODS: A comprehensive examination of 90 patients with Alzheimer's disease, vascular dementia and glaucoma was conducted. The patients were divided into three groups of 30 people each. The groups were comparable by gender and age and initial socio-economic status. All patients underwent a comprehensive neurological and neuropsychological study as well as optical coherence tomography. RESULTS AND CONCLUSION: The results of optical coherence tomography in Alzheimer's disease and glaucoma reveal retinal changes in the perifocal region in the upper and lower quadrants. In patients with vascular dementia, the process is observed in the foveal (central) region of the retina, which can be considered as a potential biomarker of the neurodegenerative damage. The severity of cognitive deficit in the Alzheimer's disease group correlates with the degree of degeneration in the layers of the peripapillary layer of the nerve fibers of the retina of the temporal region, the perifocal region of the lower quadrant of the retina, ganglion cells, and the inner plexiform layers of the retina. In the vascular dementia group, the severity of cognitive deficit positively correlates with the degree of cell degeneration in the foveal region of the inner plexiform retinal layer.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Humanos , Fibras Nervosas , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica
16.
BMJ Case Rep ; 13(10)2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33060143

RESUMO

Early case series suggest that about one-third of patients with COVID-19 present with neurological manifestations, including cerebrovascular disease, reported in 2%-6% of hospitalised patients. These are generally older patients with severe infection and comorbidities. Here we discuss the case of a previously fit and well 39-year-old man who presented with fever and respiratory symptoms, evolving in pneumonia with hypoxia but only requiring continuous positive airway pressure. After resolution of the respiratory disease, the patient developed focal neurology and was found to have bilateral occipital, thalamic and cerebellar infarcts. A diagnosis of COVID-19 central nervous system vasculopathy was made. He developed a florid neuropsychiatric syndrome, including paranoia, irritability, aggression and disinhibition, requiring treatment with antipsychotics and transfer to neurorehabilitation. Neuropsychometry revealed a wide range of cognitive deficits. The rapid evolution of the illness was matched by fast resolution of the neuropsychiatric picture with mild residual cognitive impairment.


Assuntos
Sintomas Comportamentais , Infarto Encefálico , Tronco Encefálico , Doenças Cerebelares , Cerebelo , Disfunção Cognitiva , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Adulto , Sintomas Comportamentais/diagnóstico , Sintomas Comportamentais/fisiopatologia , Sintomas Comportamentais/reabilitação , Betacoronavirus/isolamento & purificação , Infarto Encefálico/diagnóstico , Infarto Encefálico/fisiopatologia , Infarto Encefálico/psicologia , Infarto Encefálico/reabilitação , Tronco Encefálico/irrigação sanguínea , Tronco Encefálico/diagnóstico por imagem , Doenças Cerebelares/fisiopatologia , Doenças Cerebelares/psicologia , Doenças Cerebelares/reabilitação , Doenças Cerebelares/virologia , Cerebelo/irrigação sanguínea , Cerebelo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/reabilitação , Disfunção Cognitiva/virologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Humanos , Masculino , Exame Neurológico/métodos , Testes Neuropsicológicos , Pneumonia Viral/fisiopatologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Pneumonia Viral/virologia , Reabilitação Psiquiátrica/métodos , Resultado do Tratamento
17.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5486-5489, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019221

RESUMO

The ability to accurately detect onset of dementia is important in the treatment of the disease. Clinically, the diagnosis of Alzheimer Disease (AD) and Mild Cognitive Impairment (MCI) patients are based on an integrated assessment of psychological tests and brain imaging such as positron emission tomography (PET) and anatomical magnetic resonance imaging (MRI). In this work using two different datasets, we propose a behavior score-embedded encoder network (BSEN) that integrates regularly adminstrated psychological tests information into the encoding procedure of representing subject's resting-state fMRI data for automatic classification tasks. BSEN is based on a 3D convolutional autoencoder structure with contrastive loss jointly optimized using behavior scores from Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Our proposed classification framework of using BSEN achieved an overall recognition accuracy of 59.44% (3-class classification: AD, MCI and Healthy Control), and we further extracted the most discriminative regions between healthy control (HC) and AD patients.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X
18.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5498-5501, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019224

RESUMO

Early detection of dementia is crucial to devise effective interventions. Comprehensive cognitive tests, while being the most accurate means of diagnosis, are long and tedious, thus limiting their applicability to a large population, especially when periodic assessments are needed. The problem is compounded by the fact that people have differing patterns of cognitive impairment as they progress to different forms of dementia. This paper presents a novel scheme by which individual-specific patterns of impairment can be identified and used to devise personalized tests for periodic follow-up. Patterns of cognitive impairment are initially learned from a population cluster of combined normals and cognitively impaired subjects, using a set of standardized cognitive tests. Impairment patterns in the population are identified using a 2-step procedure involving an ensemble wrapper feature selection followed by cluster identification and analysis. These patterns have been shown to correspond to clinically accepted variants of Mild Cognitive Impairment (MCI), a prodrome of dementia. The learned clusters of patterns can subsequently be used to identify the most likely route of cognitive impairment, even for pre-symptomatic and apparently normal people. Baseline data of 24,000 subjects from the NACC database was used for the study.


Assuntos
Disfunção Cognitiva , Demência , Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , Humanos , Aprendizagem
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5537-5543, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019233

RESUMO

The presented paper discusses a practical application of machine learning (ML) in the so-called 'AI for social good' domain and in particular concerning the problem of a potential elderly adult dementia onset prediction. An increase in dementia cases is producing a significant medical and economic weight in many countries. Approximately 47 million older adults live with a dementia spectrum of neurocognitive disorders, according to an up-to-date statement of the World Health Organization (WHO), and this amount will triple within the next thirty years. This growing problem calls for possible application of AI-based technologies to support early diagnostics for cognitive interventions and a subsequent mental wellbeing monitoring as well as maintenance with so-called 'digital-pharma' or 'beyond a pill' therapeutical strategies. The paper explains our attempt and encouraging preliminary study results of behavioral responses analysis in a facial emotion implicit-short-term-memory learning and evaluation experiment. We present results of various shallow and deep learning machine learning models for digital biomarkers of dementia progress detection and monitoring. The discussed machine-learning models result in median accuracies right below a 90% benchmark using classical shallow and deep learning approaches for automatic discrimination of normal cognition versus a mild cognitive impairment (MCI). The classifier input features consist of an older adult emotional valence and arousal recognition responses, together with reaction times, as well as with self-reported university-level degree education and age, as obtained from a group of 35 older adults participating voluntarily in the reported dementia biomarker development project. The presented results showcase the inherent social benefits of artificial intelligence (AI) utilization for the elderly and establish a step forward to advance machine learning (ML) approaches for the subsequent employment of simple behavioral examination for MCI and dementia onset diagnostics.Clinical relevance- This manuscript establishes a behavioral and cognitive biomarker candidate potentially substituting a Montreal Cognitive Assessment (MoCA) evaluation without a paper and pencil test.


Assuntos
Disfunção Cognitiva , Demência , Idoso , Nível de Alerta , Inteligência Artificial , Biomarcadores , Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , Emoções , Humanos
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5548-5552, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019235

RESUMO

Speech analysis could provide an indicator of cognitive health and help develop clinical tools for automatically detecting and monitoring cognitive health progression. The Mini Mental Status Examination (MMSE) is the most widely used screening tool for cognitive health. But the manual operation of MMSE restricts its screening within primary care facilities. An automatic screening tool has the potential to remedy this situation. This study aims to assess the association between acoustic features of spontaneous speech and assess whether acoustic features can be used to automatically predict MMSE score. We assessed the effectiveness of paralinguistic feature set for MMSE score prediction on a balanced sample of DementiaBank's Pitt spontaneous speech dataset, with patients matched by gender and age. Linear regression analysis shows that fusion of acoustic features, age, sex and years of education provides better results (mean absolute error, MAE = 4.97, and R2 = 0.261) than acoustic features alone (MAE = 5.66 and R2 =0.125) and age, gender and education level alone (MAE of 5.36 and R2 =0.17). This suggests that the acoustic features of spontaneous speech are an important part of an automatic screening tool for cognitive impairment detection.Clinical relevance- We hereby present a method for automatic screening of cognitive health. It is based on acoustic information of speech, a ubiquitous source of data, therefore being cost-efficient, non-invasive and with little infrastructure required.


Assuntos
Disfunção Cognitiva , Fala , Acústica , Disfunção Cognitiva/diagnóstico , Humanos , Testes de Estado Mental e Demência , Testes Neuropsicológicos
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