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1.
J Psychiatr Res ; 129: 98-102, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912598

RESUMO

This study aims to evaluate the impacts of COVID-19 on cognitive functions in recovered patients and its relationship with inflammatory profiles. Twenty-nine patients recovered from COVID-19 as confirmed by negative nucleic tests for two consecutive times were recruited. A total of 29 age-, gender- and education-matched healthy controls were also recruited. The cognitive functions of all subjects were evaluated by the iPad-based online neuropsychological tests, including the Trail Making Test (TMT), Sign Coding Test (SCT), Continuous Performance Test (CPT), and Digital Span Test (DST). Blood samples from all patients were collected for examining inflammatory profiles, including interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and C-reactive protein (CRP). The relationship between cognitive functions and inflammatory profiles were analyzed by Pearson correlation. In results, although no significant differences were found in TMT, SCT, and DST between the two groups, patients with COVID-19 scored lower in the correct number of the second and third parts of CPT, they also scored higher in the missing number of the third part of CPT (all P < 0.05). In patients with COVID-19, there was a trend of significant difference for lower reaction time in the first and second parts of CPT (P = 0.050, and 0.051, respectively), as well as the lower correct number of the second part of CPT (P = 0.050). Correlation analysis showed that the reaction time for the first and second parts of CPT was positively correlated with the CRP levels (r = 0.557 and 0.410, P < 0.05). In conclusion, our findings indicated that cognitive impairments exist even in patients recovered from COVID-19, and might be possibly linked to the underlying inflammatory processes.


Assuntos
Betacoronavirus , Disfunção Cognitiva/complicações , Infecções por Coronavirus/complicações , Inflamação/complicações , Pneumonia Viral/complicações , Sobreviventes/estatística & dados numéricos , Adulto , Disfunção Cognitiva/diagnóstico , Infecções por Coronavirus/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos/estatística & dados numéricos , Pandemias , Pneumonia Viral/psicologia
2.
N Z Med J ; 133(1522): 112-127, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32994621

RESUMO

Dementia is recognised to be one of the most challenging diseases facing society, both now and in the future, with its prevalence estimated to increase substantially by 2050. The potential contributions of age-related sensory deficits have attracted little attention until recently, when a landmark study suggested that hearing loss could be a greater risk factor for dementia than hypertension, obesity, smoking, depression, physical inactivity or social isolation. Over the last decade, evidence has been gradually accumulating to suggest that the other part of the inner ear, the balance organs or 'vestibular system', might also be important in the development of cognitive dysfunction and dementia. Increasing evidence suggests that dizziness associated with vestibular dysfunction, a common reason for patients consulting their GPs, increases the risk of cognitive dysfunction, including dementia, and our understanding of the basic neurobiology of this sensory system supports this view. This paper aims to review and critically evaluate the relevant evidence.


Assuntos
Disfunção Cognitiva , Demência , Tontura , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/complicações , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/fisiopatologia , Demência/complicações , Demência/epidemiologia , Demência/fisiopatologia , Tontura/complicações , Tontura/epidemiologia , Tontura/fisiopatologia , Perda Auditiva , Humanos , Fatores de Risco , Doenças Vestibulares
4.
Medicine (Baltimore) ; 99(31): e21390, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756130

RESUMO

Prior evidence suggested that inflammation and inflammatory cytokines polymorphisms might be essential in the development of coronary heart disease (CHD) and cognitive decline. The following study investigated the associations between interleukin-35 (IL-35) polymorphisms and cognitive decline in CHD patients over a 2-year period.CHD patients were enrolled between January 2015 and January 2016. Cognitive function, including memory, orientation, verbal and attention were assessed using Telephone Interview for Cognitive Status-Modified (TICS-m) during a 2-year follow-up. Genotypes of the single nucleotide polymorphisms (SNPs), including rs2243115, rs568408, rs582054, rs583911, rs428253, rs4740 and rs393581 of IL-35 were examined by MassArray (Sequenom). The differences of TICS-m score between 2-year interval were used to estimate the cognitive decline; linear regression model was used to analyze the association between IL-35 polymorphisms and cognitive decline in CHD patients after a 2-year follow-up.The mean age of study individuals was 60.58 (±7.86) years old. There were 255 (68.5%) males and 117 (31.5%) female patients. The TICS-m scores, including overall cognition score, verbal attention and memory scores gradually decreased over a 2 year follow up period (P < .001, respectively), whereas there was no difference in orientation function score between the 1-year and 2-year follow-up (P = .448). Furthermore, after adjusting for age, sex, history of hypertension(HT) and Diabetes mellitus(DM), smoking, education, Therapy regimen (PCI, CABG, medication) left ventricular ejection fraction (LVEF), and the severity of coronary artery stenosis (Gensini score), no association was found between IL-35 rs2243115, rs568408, rs582054, rs583911, rs428253, rs4740 genotypes and cognitive decline in CHD patients over a 2-year period.Our data reveled that IL-35 polymorphisms was not associated with cognitive decline in CHD patients over a 2-year period. Yet, further studies are needed to confirm the role of cytokine gene polymorphisms in cognitive decline among CHD patients.


Assuntos
Disfunção Cognitiva/sangue , Doença das Coronárias/sangue , Interleucinas/sangue , Idoso , Disfunção Cognitiva/complicações , Doença das Coronárias/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Estudos Retrospectivos
5.
J Clin Psychiatry ; 81(4)2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32726521

RESUMO

OBJECTIVE: To review the efficacy of antidepressants and other therapeutic agents for the treatment of cognitive impairment in adults with major depressive disorder (MDD). DATA SOURCES: We conducted a database search of MEDLINE, PsycINFO, and Embase through Ovid on May 7, 2019. The year of publication was not restricted. The search terms "Major Depressive Disorder," "depress*," "cognit*," and "therapeutics" were used. STUDY SELECTION: The studies included in this review were clinical trials of antidepressants and other therapeutic agents in MDD populations. Participants were aged between 18 and 65 years and had a DSM-III, -IV, or -5 diagnosis of MDD. In total, 2,045 research papers were screened, 53 full-text articles were assessed, and 26 articles were eligible to be included in this systematic review. DATA EXTRACTION: The data and quality of research papers were assessed and screened by 2 independent reviewers. Discrepancies were resolved through a third reviewer. RESULTS: Overall, studies demonstrated that tricyclic antidepressants do not have procognitive effects, while vortioxetine and bupropion have demonstrated procognitive effects in MDD populations relative to selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Several non-antidepressant agents, such as modafinil, amphetamines, and erythropoietin, have also demonstrated significant positive effects on cognition in depression. CONCLUSIONS: Present-day antidepressants and other agents have demonstrated procognitive effects in MDD, but the findings between various agents are mixed. Further research looking at objective measures of cognitive performance would be helpful to obtain more definitive results regarding the efficacy of therapeutics for cognitive impairment in MDD.


Assuntos
Antidepressivos/uso terapêutico , Disfunção Cognitiva/tratamento farmacológico , Transtorno Depressivo Maior/tratamento farmacológico , Psicotrópicos/uso terapêutico , Disfunção Cognitiva/complicações , Transtorno Depressivo Maior/complicações , Humanos
6.
Neurology ; 95(7): e839-e846, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32669394

RESUMO

OBJECTIVE: Increasing evidence supports an association between midlife cardiovascular risk factors (CVRFs) and risk of dementia, but less is known about whether CVRFs influence cognition in midlife. We examined the relationship between CVRFs and midlife cognitive decline. METHODS: In 2,675 black and white middle-aged adults (mean age 50.2 ± 3.6 years, 57% female, 45% black), we measured CVRFs at baseline: hypertension (31%), diabetes mellitus (11%), obesity (43%), high cholesterol (9%), and current cigarette smoking (15%). We administered cognitive tests of memory, executive function, and processing speed at baseline and 5 years later. Using logistic regression, we estimated the association of CVRFs with accelerated cognitive decline (race-specific decline ≥1.5 SD from the mean change) on a composite cognitive score. RESULTS: Five percent (n = 143) of participants had accelerated cognitive decline over 5 years. Smoking, hypertension, and diabetes mellitus were associated with an increased likelihood of accelerated decline after multivariable adjustment (adjusted odds ratio [AOR] 1.65, 95% confidence interval [CI] 1.00-2.71; AOR 1.87, 95% CI 1.26-2.75; AOR 2.45, 95% CI 1.54-3.88, respectively), while obesity and high cholesterol were not associated with risk of decline. These results were similar when stratified by race. The likelihood of accelerated decline also increased with greater number of CVRFs (1-2 CVRFs: AOR 1.77, 95% CI 1.02-3.05; ≥3 CVRFs: AOR 2.94, 95% CI 1.64-5.28) and with Framingham Coronary Heart Disease Risk Score ≥10 (AOR 2.29, 95% CI 1.21-4.34). CONCLUSIONS: Midlife CVRFs, especially hypertension, diabetes mellitus, and smoking, are common and associated with accelerated cognitive decline at midlife. These results identify potential modifiable targets to prevent midlife cognitive decline and highlight the need for a life course approach to cognitive function and aging.


Assuntos
Doenças Cardiovasculares/complicações , Disfunção Cognitiva/complicações , Disfunção Cognitiva/etiologia , Hipertensão/complicações , Adulto , Idoso , Envelhecimento/fisiologia , Doenças Cardiovasculares/prevenção & controle , Cognição/fisiologia , Disfunção Cognitiva/prevenção & controle , Feminino , Humanos , Hipertensão/prevenção & controle , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Fatores de Risco
7.
Geriatr Gerontol Int ; 20(10): 867-872, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32725916

RESUMO

AIM: Subjective memory complaints (SMC) have attracted attention in recent years in relation to the early stages of dementia. However, it is not clear whether SMC are related to social and leisure activities. The aim of this study was to evaluate SMC in relation to activities in community-dwelling older adults. METHODS: A questionnaire inquiring about SMC and social and leisure activities was sent to 14 850 people aged ≥65 years residing in Toyoake City, as part of the Toyoake Integrated Care Study. After a preliminary analysis, we targeted respondents aged ≥70 years. Therefore, 6685 people were included in the analysis. Three question items were used detecting SMC: the feeling of a memory problem (SMC-1), memory loss pointed out by others (SMC-2) and difficulty in recalling today's date (SMC-3). Logistic regression was carried out to determine the relationship between SMC and activities. RESULTS: In response to SMC-1, 2 and 3, 45.3%, 13.3% and 23.5% participants, respectively, agreed with the statement. Social and leisure activities were negatively associated with SMC-2 and SMC-3, after controlling for confounding factors (SMC-2: odds ratio 0.76, 95% confidence interval 0.65-0.89; SMC-3: odds ratio 0.79, 95% confidence interval 0.70-0.90). However, a significant increase in participation in social and leisure activities was associated with a positive response to SMC-1 (SMC-1: odds ratio 1.24, 95% confidence interval 1.12-1.38). Conclusion A relationship was observed between SMC and social and leisure activities in community-dwelling older people, although differences in the impact of SMC were seen depending on the question asked. Geriatr Gerontol Int 2020; 20: 867-872.


Assuntos
Atividades de Lazer/psicologia , Transtornos da Memória/epidemiologia , Memória/fisiologia , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/complicações , Estudos Transversais , Demência/complicações , Depressão/epidemiologia , Feminino , Humanos , Vida Independente , Japão/epidemiologia , Masculino , Inquéritos e Questionários
8.
Gerontology ; 66(4): 351-361, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32512565

RESUMO

BACKGROUND: Vision loss and hearing loss are common in later life and are associated with cognitive impairment and neuropsychiatric symptoms. There is a need to better understand how individual characteristics, such as poor sensory functioning, are linked with familial well-being. OBJECTIVES: The aim of this study was to investigate whether, among persons with neuropsychiatric symptoms, age-related sensory loss is related to increased emotional distress reported by their family and friends. METHODS: The sample comprised 537 participant-informant dyads from the Personality and Total Health through Life (PATH) study, a community-based cohort. Participants were aged between 72 and 79 years (56% men), and all were reported to exhibit at least 1 neuropsychiatric symptom. Informants were participants' spouse (50%), child (35%), friend (7%), or other relatives (7%). Neuropsychiatric symptom-related distress of friends and family was assessed with the distress subscale of the Neuropsychiatric Inventory (NPI). Sensory functioning in participants was assessed by visual acuity and self-reported hearing difficulties. Ordinal logistic regression analyses estimated the association between sensory problems and NPI distress. RESULTS: In models adjusted for informant dyadic relationship and socio-demographics, both lower visual acuity (B = 0.23, SE = 0.10) and self-reported hearing difficulty (B = 0.15, SE = 0.06) were associated with increased levels of distress. The increased informant distress associated with poor visual acuity was attenuated after adjusting for neurocognitive disorder and health conditions (p = 0.069). A significant interaction between vision and hearing remained after multivariable adjustment (χ2(1) = 6.73, p = 0.010). CONCLUSIONS: Friends and family of persons with poor visual acuity and perceived hearing difficulties report elevated levels of neuropsychiatric symptom-related distress relative to friends and family of persons with poor sensory functioning in only 1 sensory domain or unimpaired levels of vision and hearing. These findings provide evidence of the third-party effects of sensory loss in the context of neuropsychiatric symptoms, and in particular show how dual sensory loss can confer additional challenges over and above the effects of a single sensory loss.


Assuntos
Disfunção Cognitiva/complicações , Família/psicologia , Amigos/psicologia , Perda Auditiva/complicações , Transtornos da Visão/complicações , Idoso , Austrália , Estudos de Coortes , Feminino , Humanos , Vida Independente , Masculino , Testes Neuropsicológicos , Angústia Psicológica , Autorrelato , Acuidade Visual
9.
Mult Scler Relat Disord ; 42: 102163, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32388458

RESUMO

Facing the outbreak of coronavirus disease 2019 (COVID-19) pandemic, there is an urgent need to find protective or curable drugs to prevent or to stop the course of the coronavirus SARS-CoV-2 infection. Recent evidence accumulates that adamantanes, widely used in different neurological diseases, could be repurposed for COVID-19. We hereby report on a questionnaire-based study performed to assess severity of COVID-19 in patients suffering from multiple sclerosis (n=10), Parkinson's disease (n=5) or cognitive impairment (n=7). In all patients infection with SARS-CoV-2 was confirmed by rtPCR of nasopharyngeal swabs. They were receiving treatment with either amantadine (n=15) or memantine (n=7) in stable registered doses. All of them had two-week quarantine since documented exposure and none of them developed clinical manifestations of infectious disease. They also did not report any significant changes in neurological status in the course of primary nervous system disease. Above results warrant further studies on protective effects of adamantanes against COVID-19 manifestation, especially in subjects suffering from neurological disease.


Assuntos
Amantadina/uso terapêutico , Infecções Assintomáticas , Disfunção Cognitiva/tratamento farmacológico , Infecções por Coronavirus/fisiopatologia , Dopaminérgicos/uso terapêutico , Memantina/uso terapêutico , Esclerose Múltipla/tratamento farmacológico , Doença de Parkinson/tratamento farmacológico , Pneumonia Viral/fisiopatologia , Adamantano/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Disfunção Cognitiva/complicações , Infecções por Coronavirus/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Pandemias , Doença de Parkinson/complicações , Pneumonia Viral/complicações , Fatores de Proteção , Índice de Gravidade de Doença
10.
Anesth Analg ; 130(6): 1524-1533, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32384342

RESUMO

Anesthetists are increasingly faced with the challenge of delivering perioperative care to frail older people. Patients with frailty undergoing surgical intervention are at a significantly increased risk of perioperative complications, mortality, and longer length of stay. Moreover, frailty is often associated with multimorbidity and a range of geriatric syndromes including functional dependency, cognitive impairment, and malnutrition which further increases risk and complexity of care. There is a growing body of evidence that prehabilitation-intervention delivered during the preoperative period to improve overall health and function-can improve postoperative outcomes for patients undergoing surgery. However, whether this vulnerable population stand to benefit from prehabilitation is less clear. We review the evidence for prehabilitation for patients with frailty including whether the risks associated with and outcomes from surgery can be modified through comprehensive geriatric assessment.


Assuntos
Delírio/prevenção & controle , Fragilidade/cirurgia , Avaliação Geriátrica/métodos , Complicações Cognitivas Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Período Pré-Operatório , Idoso , Disfunção Cognitiva/complicações , Delírio/diagnóstico , Idoso Fragilizado , Fragilidade/terapia , Humanos , Tempo de Internação , Desnutrição/complicações , Multimorbidade , Complicações Cognitivas Pós-Operatórias/diagnóstico , Período Pós-Operatório , Cuidados Pré-Operatórios , Fatores de Risco , Resultado do Tratamento , Populações Vulneráveis
11.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(5): 528-532, 2020 May.
Artigo em Chinês | MEDLINE | ID: mdl-32434653

RESUMO

Cognitive impairment in children with benign childhood epilepsy with centrotemporal spikes (BECT) has complex etiologies and is closely associated abnormal neural networks. Multimodal magnetic resonance imaging of brain structure and function is a powerful tool for studying abnormal neural networks of cognitive impairment in epilepsy and can explore the pathogenesis of cognitive impairment in epilepsy at the level of brain structure and function by analyzing the imaging features of brain structure and function. This article reviews the research advances in multimodal magnetic resonance for cognitive impairment in children with BECT.


Assuntos
Disfunção Cognitiva , Epilepsia Rolândica , Encéfalo , Criança , Disfunção Cognitiva/complicações , Epilepsia Rolândica/complicações , Humanos , Espectroscopia de Ressonância Magnética
12.
Stroke ; 51(6): 1667-1673, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32397931

RESUMO

Background and Purpose- The ongoing ageing population is associated with an increasing number of patients with stroke who have preexisting cognitive impairment. This study aimed to evaluate clinical severity in patients with ischemic stroke according to prestroke cognitive status. Methods- Patients with ischemic stroke were prospectively identified among residents of Dijon, France using a population-based registry (2013-2017). Prestroke cognitive status (no impairment, mild cognitive impairment [MCI], or dementia) was recorded, and severity at stroke onset was measured using the National Institutes of Health Stroke Scale (NIHSS) score. Association between prestroke cognitive status and severity was evaluated using ordinal regression analysis models in which the NIHSS score was considered as a categorical variable. Results- Among the 1048 patients (mean age, 76.3±15.2 years; 54.0% women), a greater severity was observed in those with MCI (n=132; median NIHSS: 6; interquartile range, 2-15), and those with dementia (n=164; median NIHSS: 7; interquartile range, 3-16), than in patients without cognitive impairment (n=752; median NIHSS: 3; interquartile range, 1-9). MCI (odds ratio [OR], 1.70 [95% CI, 1.21-2.38]; P=0.002) and dementia (OR, 2.24 [95% CI, 1.65-3.04]; P<0.001) were both associated with a greater severity at onset. The association was still observed after adjustment for clinical variables and proximal arterial occlusion (OR, 1.52 [95% CI, 1.02-2.28]; P=0.04 for MCI; OR, 2.16 [95% CI, 1.45-3.22]; P<0.001 dementia). Further adjustment for prestroke handicap slightly reduced the magnitude of the association (OR, 1.49 [95% CI, 0.98-2.25]; P=0.06 for MCI, and OR, 1.98 [95% CI, 1.26-3.12]; P=0.02 for dementia). The greater severity in patients with prestroke cognitive impairment was not specifically driven by a more severe impairment of either motor or language function. Conclusions- Patients with preexisting cognitive impairment suffered more severe ischemic stroke. This result could reflect a lower brain tolerance of acute ischemia. Further studies are needed to explore the underlying mechanisms that could be targeted from therapeutic perspectives focusing on neuroprotection.


Assuntos
Sistema de Registros , Acidente Vascular Cerebral , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/complicações , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/fisiopatologia , Feminino , França/epidemiologia , Humanos , Masculino , Estudos Prospectivos , Índice de Gravidade de Doença , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia
13.
Gen Hosp Psychiatry ; 65: 47-53, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32470824

RESUMO

INTRODUCTION: Neuropsychiatric manifestations of the coronavirus disease 2019 (COVID-19) have been described, including anosmia, ageusia, headache, paresthesia, encephalitis and encephalopathy. Little is known about the mechanisms by which the virus causes central nervous system (CNS) symptoms, and therefore little guidance is available regarding potential workup or management options. CASES: We present a series of four consecutive cases, seen by our psychiatry consultation service over a one-week period, each of which manifested delirium as a result of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). DISCUSSION: The four cases highlighted here all occurred in older patients with premorbid evidence of cognitive decline. Unique features seen in multiple cases included rigidity, alogia, abulia, and elevated inflammatory markers. In all four cases, a change in mental status was the presenting symptom, and three of the four cases lacked significant respiratory symptoms. In addition to discussing unique features of the cases, we discuss possible pathophysiologic explanations for COVID-19 delirium. CONCLUSIONS: Delirium should be recognized as a potential feature of infection with SARS-CoV-2 and may be the only presenting symptom. Based on the high rates of delirium demonstrated in prior studies, hospitals should consider adding mental status changes to the list of testing criteria. Further research is needed to determine if delirium in COVID-19 represents a primary encephalopathy heralding invasion of the CNS by the virus, or a secondary encephalopathy related to systemic inflammatory response or other factors.


Assuntos
Encefalopatias/etiologia , Infecções por Coronavirus/complicações , Delírio/etiologia , Pandemias , Pneumonia Viral , Idoso , Idoso de 80 Anos ou mais , Encefalopatias/virologia , Disfunção Cognitiva/complicações , Infecções por Coronavirus/patologia , Delírio/virologia , Feminino , Humanos , Masculino
16.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(3. Vyp. 2): 16-22, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32307425

RESUMO

Cognitive impairment is common in poststroke patients. Today in rehabilitation programs the specialists use the vestibular stimulation including biological feedback to supporting reaction for treatment poststroke cognitive impairment. These studies show the relationship of vestibular function with memory, attention, spatial orientation, navigation, mental representation of three-dimensional space and other cognitive functions. It makes possible to build rehabilitation programs for patients with stroke.


Assuntos
Biorretroalimentação Psicológica , Disfunção Cognitiva/complicações , Disfunção Cognitiva/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Testes de Função Vestibular , Atenção , Cognição , Humanos , Memória , Percepção Espacial , Navegação Espacial
17.
Med Care ; 58(7): 601-609, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32287048

RESUMO

BACKGROUND: Many older adults receive caregiving; however, less is known about how a change in a care recipient's functional activity limitations [instrumental activities of daily living (IADL) and basic activities of daily living (ADL)] as well as their cognitive impairment influence the amount of caregiving received. METHODS: Using the Health and Retirement Study (2002-2014) we identified community-dwelling respondents with Alzheimer disease and related dementias (ADRD; n=674), cognitive impairment no dementia (CIND; n=530), and no cognitive impairment (n=6126). We estimated a series of two-part regression models to identify the association between care recipients' level of cognitive impairment, change in total number of IADL/ADL limitations and amount of caregiving received. RESULTS: Persons with ADRD received 235.8 (SD=265.6) monthly hours of care compared with 26.0 (SD=92.6) and 6.0 (SD=40.7) for persons with CIND and no cognitive impairment, respectively. An increase in one IADL/ADL limitation resulted in persons with ADRD and CIND receiving 4.90 (95% confidence interval: 3.40-6.39) and 1.43 (95% confidence interval: 0.17-2.69) more hours of caregiving than persons with no cognitive impairment. Increases in total IADL/ADL limitations were associated with persons with ADRD, but not CIND, receiving more days of caregiving and having more caregivers than persons with no cognitive impairment. CONCLUSIONS: Compared with persons with no cognitive impairment, increases in IADL/ADL limitations disproportionally increases the caregiving received for persons with ADRD. Policies and programs must pay attention to functional impairments among those living with ADRD.


Assuntos
Cuidadores/normas , Disfunção Cognitiva/complicações , Pessoas com Deficiência/psicologia , Desempenho Físico Funcional , Idoso , Idoso de 80 Anos ou mais , Cuidadores/estatística & dados numéricos , Transtornos Cognitivos/complicações , Disfunção Cognitiva/psicologia , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Avaliação Geriátrica/métodos , Humanos , Masculino
19.
Artigo em Russo | MEDLINE | ID: mdl-32323954

RESUMO

The review presents current data on the nature of cognitive deficit in children with hyperkinetic disorder, and possible pathophysiological mechanisms of the disease. Considering possible neurobiological components of hyperkinetic disorder, attention is given to pathological functional connections underlying specific clinical manifestations of the disease.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Disfunção Cognitiva/complicações , Atenção , Criança , Cognição , Humanos
20.
Otolaryngol Head Neck Surg ; 163(2): 348-355, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32312167

RESUMO

OBJECTIVE: We explored the associations of age-related central auditory processing disorder (CAPD) with mild cognitive impairment (MCI) and dementia in an older population-based cohort in Apulia, Southern Italy (GreatAGE Study). STUDY DESIGN: Cross-sectional data from a population-based study. SETTING: Castellana Grotte, Bari, Italy. SUBJECTS AND METHODS: Between 2013 and 2018, MCI, dementia, age-related CAPD (no disabling hearing loss and <50% score on the SSI-ICM test [Synthetic Sentence Identification-Ipsilateral Competing Message]), neurologic and neuropsychological examinations, and serum metabolic biomarkers assays were investigated on 1647 healthy volunteers aged >65 years. RESULTS: The prevalences of age-related CAPD, MCI, and dementia were 14.15%, 15.79%, and 3.58%, respectively. Among the subjects with MCI and dementia, 19.61% and 42.37% had age-related CAPD. In the regressive models, age-related CAPD was associated with MCI (odds ratio, 1.50; 95% CI, 1.01-2.21) and dementia (odds ratio, 2.23; 95% CI, 1.12-4.42). Global cognition scores were positively associated with increasing SSI-ICM scores in linear models. All models were adjusted for demographics and metabolic serum biomarkers. CONCLUSION: The tight association of age-related CAPD with MCI and dementia suggests the involvement of central auditory pathways in neurodegeneration, but it is not clear which is the real direction of this association. However, CAPD is a possible diagnostic marker of cognitive dysfunction in older patients.


Assuntos
Disfunção Cognitiva/complicações , Demência/complicações , Transtornos do Desenvolvimento da Linguagem/complicações , Fatores Etários , Idoso , Disfunção Cognitiva/epidemiologia , Estudos Transversais , Demência/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Transtornos do Desenvolvimento da Linguagem/epidemiologia , Masculino
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