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1.
Medicine (Baltimore) ; 99(2): e18501, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914020

RESUMO

The frailty represents a key determinant of elderly clinical assessment, especially because it allows the identification of risk factors potentially modifiable by clinical and therapeutic interventions. The frailty assessment in elderly patients usually is made by using of Fried criteria. However, to assess the frailty in cirrhotic patients, multiple but different tools are used by researchers. Thus, we aimed to compare frailty prevalence in elderly patients with well-compensated liver cirrhosis and without cirrhosis, according to Fried criteria.Among 205 elderly patients screened, a total of 148 patients were enrolled. The patients were divided into 2 groups according to the presence/absence of well-compensated liver cirrhosis.After clinical examination with conventional scores of cirrhosis, all patients underwent anthropometric measurements, nutritional, biochemical, comorbidity, and cognitive performances. Frailty assessment was evaluated according to Fried frailty criteria.Unexpectedly, according to the Fried criteria, non-cirrhotic patients were frailer (14.2%) than well-compensated liver cirrhotic patients (7.5%). The most represented Fried criterion was the unintentional weight loss in non-cirrhotic patients (10.1%) compared to well-compensated liver cirrhotic patients (1.4%). Moreover, cumulative illness rating scale -G severity score was significantly and positively associated with frailty status (r = 0.234, P < .004). In a multivariate linear regression model, only female gender, body mass index and mini nutritional assessment resulted associated with frailty status, independently of other confounding variables.Despite the fact that elderly cirrhotic patients are considered to be frailer than the non-cirrhotic elderly patient, relying solely on "mere visual appearance," our data show that paradoxically non-cirrhotic elderly patients are frailer than elderly well-compensated liver cirrhotic patients. Thus, clinical implication of this finding is that frailty assessment performed in the well-compensated liver cirrhotic patient can identify those cirrhotic patients who may benefit from tailored interventions similarly to non-cirrhotic elderly patients.


Assuntos
Fragilidade/epidemiologia , Hepatite C/complicações , Cirrose Hepática/complicações , Cirrose Hepática/epidemiologia , Idoso , Índice de Massa Corporal , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Comorbidade , Estudos Transversais , Feminino , Hepacivirus/isolamento & purificação , Hepatite C/epidemiologia , Humanos , Cirrose Hepática/diagnóstico , Masculino , Avaliação Nutricional , Prevalência , Fatores de Risco , Índice de Gravidade de Doença
2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 10-17, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825384

RESUMO

Cognitive decline is one of the main manifestations of brain damage especially in the elderly. In some cases, cognitive dysfunction stayed within normal aging and do not lead to social dis-adaptation, while in other cases severe cognitive impairment develops when daily activity and domestic independence is affected. However, these disturbances are preceded by prolonged intermediate stage, when cognitive deficit do not reach the degree of dementia, but already do not match normal aging. Initial terms (for example benign senescent forgetfulness) were interpreted as aging phenomena. Later this state named as mild cognitive impairment (MCI) is considered as prodromal phase of demented disease. Up to date studies allow us consider MCI as an integral part of the complex structure of overlapping syndromes ('pre-cognitive impairment'), the allocation of which have not only theoretical, but also pragmatic meaning, allow us, on the one hand, to plan clinical trials series with various therapeutic targets, and, on the other hand, to form rational approach to the modern management of patients with MCI and pre-MCI in clinical practice.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Demência , Idoso , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/diagnóstico , Progressão da Doença , Humanos , Transtornos da Memória
3.
Artigo em Russo | MEDLINE | ID: mdl-31793550

RESUMO

Article is devoted to topical issues of complex diagnosis and treatment of the consequences of traumatic brain injury (TBI) in children, adolescents and adults. Craniocerebral trauma is one of the most important problems of modern neurology, due to the high frequency and severity of disability. In recent years, there has been a steady increase in effects of TBI, a significant part of which are asthenic, autonomic, cognitive, emotional and motor disorders. Factors affecting the severity of the consequences of TBI are: the severity of the injury, the age, at which the injury occurred, the time elapsed since the injury, the localization of the lesion. After mild TBI, the structure of cognitive impairment is dominated by memory and attention disorders (75%), visual-motor coordination, as well as asthenic disorders (88%), chronic headaches (95%). After moderate and severe TBI, there are more pronounced impairment of cognitive and motor functions accompanied by pathological neurological symptoms in 94-100% of children, which leads to difficulties in learning, self-service and has a negative impact on social adaptation. The article describes in detail the modern methods of complex diagnosis, as well as pathogenetically justified methods of drug therapy of cognitive disorders in patients with the consequences of TBI. The high efficacy of the modern cytoprotective drug Cytoflavin in the treatment of the effects of TBI is shown.


Assuntos
Concussão Encefálica , Lesões Encefálicas Traumáticas , Disfunção Cognitiva , Transtornos da Memória , Adolescente , Adulto , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico , Concussão Encefálica/terapia , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Criança , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/terapia , Humanos , Memória , Transtornos da Memória/diagnóstico , Transtornos da Memória/etiologia , Transtornos da Memória/terapia
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(10): 103-110, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31793551

RESUMO

The concept of mild cognitive impairment is one of the promising directions for studying the predementia stages of different diseases. The feasibility of studying this phenomenon is due not only to a high risk of dementia, but also the potential reversibility of cognitive decline in old age. Long-term follow-up of patients shows different trajectories of cognitive decline in aging. The study of risk factors for the progression of moderate cognitive impairment provided an opportunity to highlight new horizons of prevention of dementia of various etiologies. Despite the insufficient effectiveness of drug therapy in patients with moderate cognitive impairment, exploring the opportunities for possible treatment of their subtypes seems promising from the point of view of improving clinical symptoms and a possible reduction in the rate of disease progression.


Assuntos
Disfunção Cognitiva , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/terapia , Progressão da Doença , Humanos , Fatores de Risco
5.
BMC Neurol ; 19(1): 269, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31684893

RESUMO

BACKGROUND: To determine whether items of the Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) could discriminate among cognitively normal controls (NC), and those with mild cognitive impairment (MCI), mild Alzheimer's disease (AD), and moderate-severe (AD), as well as their sensitivity and specificity. METHODS: MCI (n = 456), mild AD (n = 502) and moderate-severe AD (n = 102) patients were recruited from the memory clinic, Huashan Hospital, Shanghai, China. NC (n = 329) were recruited from health checkup outpatients. Five MoCA-BC item scores were collected in interviews. RESULTS: The MoCA-BC orientation test had high sensitivity and specificity for discrimination among MCI, mild AD and moderate-severe AD. The delayed recall memory test had high sensitivity and specificity for MCI screening. The verbal fluency test was efficient for detecting MCI and differentiating AD severity. CONCLUSIONS: Various items of the MoCA-BC can identify MCI patients early and identify the severity of dementia.


Assuntos
Doença de Alzheimer , Testes de Estado Mental e Demência , Doença de Alzheimer/classificação , Doença de Alzheimer/diagnóstico , China , Disfunção Cognitiva/classificação , Disfunção Cognitiva/diagnóstico , Humanos , Sensibilidade e Especificidade , Traduções
6.
Medicine (Baltimore) ; 98(48): e18189, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770275

RESUMO

Sparse is the research on the relationship between iron metabolism and mild cognitive impairment (MCI) in adults aged over 60 years with non-alcoholic fatty liver disease (NAFLD). The soluble transferrin receptor (sTfR), serum iron (SI), serum ferritin (SF), transferrin (TRF) and hemoglobin (HB) are indicators of iron metabolism.This study examined whether iron metabolism is associated with cognitive impairment in older individuals.A cross-sectional study was held in patients from a Chinese center. Individuals with NAFLD aged over 60 years were included if they did not have excessive alcohol intake and were free of stroke or dementia. Their cognitive function was assessed by the same neurologist. 3.0T H proton magnetic resonance spectroscopy (H-MRS) was performed to evaluate the hippocampus of the participants without contraindication. t test and Chi-square test were used to analyze the data. Binary logistic regression was used for correlation analysis.Fifty four (54%) of participants were diagnosed with MCI by the psychiatrist. MCI was significantly associated with higher sTfR after adjustment of all the covariates (OR = 2.565, 95%CI: 1.334∼4.934; P = .005). No statistically significant associations were observed between MCI and age or blood glucose or choline (Cho) /creatine (Cr) of theright hippocampus head.Increased age and low levels of sTfR and HB were associated with MCI in NAFLD individuals aged over 60 years.


Assuntos
Disfunção Cognitiva , Hemoglobinas/análise , Hipocampo/diagnóstico por imagem , Ferro , Hepatopatia Gordurosa não Alcoólica , Receptores da Transferrina/sangue , Idoso , China/epidemiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/metabolismo , Correlação de Dados , Estudos Transversais , Feminino , Ferritinas/análise , Humanos , Ferro/sangue , Ferro/metabolismo , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/psicologia , Transferrina/análise
7.
Medicine (Baltimore) ; 98(42): e17626, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626144

RESUMO

To establish a nomogram model to predict early cognitive impairment after supratentorial spontaneous intracranial hematoma in adult patients.A retrospective cohort study was held between January 2016 and October 2018. One hundred twenty seven out of 170 consecutive patients with supratentorial spontaneous intracranial hematoma were enrolled in this study. They were divided into development (n = 92) and validation (n = 35) dataset according to their admission time. Mini-mental State Examination (MMSE) was conducted between the third and the sixth month after the onset of stroke. MMSE ≤ 24 was considered as cognitive impairment. Univariate and multivariate logistic regression was used to screen for independent risk factors which correlate with cognitive impairment on the development dataset. A nomogram was built based on Akaike Information Criterion (AIC). Receiver operating characteristic (ROC) curve and calibration curve on development and validation dataset was drawn with each area under the curves (AUC) calculated. The decision curve analysis was also conducted with the development dataset.The bleeding volume, Glasgow Coma Scale (GCS), and intraventricular hemorrhage (IVH) are the most significant risk factors which may cause cognitive impairment both in the univariate and multivariate analysis. The finial model performed good discrimination ability on both development and validation dataset with AUC 0.911 and 0.919. Most patients would benefit from the model according to the decision curve analysis.A nomogram, constructed based on bleeding volume, GCS, and IVH can provide a feasible tool to evaluate cognitive impairment after supratentorial spontaneous intracranial hematoma in adult patients.


Assuntos
Hemorragia Cerebral/complicações , Cognição/fisiologia , Disfunção Cognitiva/diagnóstico , Hematoma/complicações , Nomogramas , Adulto , Hemorragia Cerebral/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Feminino , Seguimentos , Hematoma/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença
8.
Einstein (Sao Paulo) ; 18: eAO4752, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31664323

RESUMO

OBJECTIVE: To evaluate the epidemiological profile of patients seen at a dementia outpatient clinic. METHODS: A retrospective study conducted by medical record review searching data on sex, race, age, schooling level, and diagnosis of patients seen from 2008 to 2015. RESULTS: A total of 760 patients were studied, with a predominance of female (61.3%; p<0.0001). The mean age was 71.2±14.43 years for women and 66.1±16.61 years for men. The most affected age group was 71 to 80 years, accounting for 29.4% of cases. In relation to race, 96.3% of patients were white. Dementia was diagnosed in 68.8% of patients, and Alzheimer's disease confirmed in 48.9%, vascular dementia in 11.3%, and mixed dementia in 7.8% of cases. The prevalence of dementia was 3% at 70 years and 25% at 85 years. Dementia appeared significantly earlier in males (mean age 68.5±15.63 years). As to sex distribution, it was more frequent in women (59.6%) than in men (40.4%; p<0.0001; OR=2.15). People with higher schooling level (more than 9 years) had a significantly younger age at onset of dementia as compared to those with lower schooling level (1 to 4 years; p=0.0007). CONCLUSION: Most patients seen in the period presented dementia, and Alzheimer was the most prevalent disease. Women were more affected, and men presented young onset of the disease. Individuals with higher schooling level were diagnosed earlier than those with lower level.


Assuntos
Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Pacientes Ambulatoriais/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Brasil/epidemiologia , Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , Escolaridade , Feminino , Hospitais Privados/estatística & dados numéricos , Humanos , Masculino , Registros Médicos , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Distribuição por Sexo , Adulto Jovem
9.
Z Gerontol Geriatr ; 52(Suppl 4): 273-281, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31664583

RESUMO

BACKGROUND AND OBJECTIVE: Mobility decline and worsening of the cognitive status are all too often the result of acute hospital treatment in older patients. This is particularly pronounced in patients with pre-existing cognitive impairment. This study strived to analyze the routines of geriatric acute care and identify reasons and triggers for sedentary behavior during acute hospitalization of cognitively impaired inpatients. METHODS AND PATIENTS: A sample of 20 moderately cognitively impaired geriatric inpatients (average age 84 years) were recruited on an acute care ward. Information on persons attending the patient, daytime, location, context, patient's activity behavior and difficulty of action were collected by behavioral mapping over a period of 35 1­min timeslots and extrapolated to a period of 525 min. Routines were further analyzed via semi-structured interviews with five healthcare professionals (HCP). RESULTS: Relevant relations between various categorical and ordinal variables, such as patients' activity behavior, persons attending the patient, daytime, location, difficulty of action and contextual factors were found. Extrapolated data showed that patients spent 396.9 min (75%) in their room, 342.0 min (65%) were spent alone and 236.2 min (45%) lying in bed. The time patients spent alone was grossly underestimated by HCP. CONCLUSION: Time spent without company, lacking meaningful activities and continuous bedridden periods due to missing demands to leave the room might have led to time spent inactive and alone. These seem to be strong predictors for sedentariness. Routines of acute care should be reorganized to increase physical activity and thereby reduce sedentary behavior of this patient group.


Assuntos
Atividades Cotidianas , Disfunção Cognitiva/psicologia , Pacientes Internados/psicologia , Comportamento Sedentário , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/diagnóstico , Hospitalização , Humanos , Projetos Piloto
10.
Wiad Lek ; 72(9 cz 2): 1715-1722, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-31622253

RESUMO

OBJECTIVE: Introduction: Cognitive limitations are a serious health and social problem, which concerns elderly people. Effective prevention and treatment of cognitive dysfunction is one of the challenges of modern medicine. There is not enough consistent data in the literature to indicate to indicate the relationship between various clinical and demographic factors with cognitive functioning in different age ranges. The aim: To analyze clinical and demographic predictors of mild cognitive impairment by age group. PATIENTS AND METHODS: Material and methods: The analysis included 817 participants (669 with normal cognitive function and 148 people with MCI). The evaluation of the level of depressive symptoms was measured by the Short Form Geriatric Depression Scale. All participants were screened for cognitive functioning using the Mini-Mental State Examination and Addenbrooke's Cognitive Examination-III. Different cognitive domains were evaluated with different neuropsychological tools: the Rey Auditory Verbal Learning test, Clock Drawing test, Verbal Fluency test, Digit Span Test and Trail Making test. RESULTS: Results: It has been shown that independently associated with MCI ware age (OR = 1.09, 95% CI: 1.05-1.13) and level of education (OR = 0.75, 95% CI: 0.69-0.81). Depending on the age, it turned out that in the younger MCI group, age, education and depression were significant, and the age and level of education were significant in the older MCI group. CONCLUSION: Conclusions: The identification of cognitive dysfunctions is an important element of the diagnostic and therapeutic process.


Assuntos
Cognição , Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Fatores Etários , Estudos Transversais , Escolaridade , Humanos
11.
BMC Infect Dis ; 19(1): 833, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31590634

RESUMO

BACKGROUND: Persistent symptoms attributed to Lyme borreliosis often include self-reported cognitive impairment. However, it remains unclear whether these symptoms can be substantiated by objective cognitive testing. METHODS: For this observational study, cognitive performance was assessed in 280 adults with persistent symptoms attributed to Lyme borreliosis (as part of baseline data collected for the Dutch PLEASE study). Cognitive testing covered the five major domains: episodic memory, working memory / attention, verbal fluency, information-processing speed and executive function. Patients' profiles of test scores were compared to a large age-, education- and sex-adjusted normative sample using multivariate normative comparison. Performance validity was assessed to detect suboptimal effort, and questionnaires were administered to measure self-reported cognitive complaints, fatigue, anxiety, depressive symptoms and several other psychological factors. RESULTS: Of 280 patients, one was excluded as the test battery could not be completed. Of the remaining 279 patients, 239 (85.4%) displayed sufficient performance validity. Patients with insufficient performance validity felt significantly more helpless and physically fatigued, and less orientated. Furthermore, they had a lower education level and less often paid work. Of the total study cohort 5.7% (n = 16) performed in the impaired range. Among the 239 patients who displayed sufficient performance validity, 2.9% (n = 7) were classified as cognitively impaired. No association between subjective cognitive symptoms and objective impairment was found. CONCLUSIONS: Only a small percentage of patients with borreliosis-attributed persistent symptoms have objective cognitive impairment. Performance validity should be taken into account in neuropsychological examinations of these patients. Self-report questionnaires are insufficiently valid to diagnose cognitive impairment. TRIAL REGISTRATION: ClinicalTrials.gov NCT01207739 . Registered 23 September 2010.


Assuntos
Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Doença de Lyme/complicações , Doença de Lyme/psicologia , Adulto , Ansiedade/diagnóstico , Atenção , Estudos de Coortes , Depressão/diagnóstico , Função Executiva , Fadiga/diagnóstico , Feminino , Humanos , Masculino , Memória Episódica , Memória de Curto Prazo , Pessoa de Meia-Idade , Testes Neuropsicológicos , Autorrelato
12.
Medicine (Baltimore) ; 98(39): e17303, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574857

RESUMO

Treatment with nitisinone (NTBC) has brought about a drastic improvement in the treatment and prognosis of hereditary tyrosinemia type I (HT1). We conducted a retrospective observational multicentric study in Spanish HT1 patients treated with NTBC to assess clinical and biochemical long-term evolution.We evaluated 52 patients, 7 adults and 45 children, treated with NTBC considering: age at diagnosis, diagnosis by clinical symptoms, or by newborn screening (NBS); phenotype (acute/subacute/chronic), mutational analysis; symptoms at diagnosis and clinical course; biochemical markers; doses of NTBC; treatment adherence; anthropometric evolution; and neurocognitive outcome.The average follow-up period was 6.1 ±â€Š4.9 and 10.6 ±â€Š5.4 years in patients with early and late diagnosis respectively. All patients received NTBC from diagnosis with an average dose of 0.82 mg/kg/d. All NBS-patients (n = 8) were asymptomatic at diagnosis except 1 case with acute liver failure, and all remain free of liver and renal disease in follow-up. Liver and renal affectation was markedly more frequent at diagnosis in patients with late diagnosis (P < .001 and .03, respectively), with ulterior positive hepatic and renal course in 86.4% and 93.2% of no-NBS patients, although 1 patient with good metabolic control developed hepatocarcinoma.Despite a satisfactory global nutritional evolution, 46.1% of patients showed overweight/obesity. Interestingly lower body mass index was observed in patients with good dietary adherence (20.40 ±â€Š4.43 vs 24.30 ±â€Š6.10; P = .08) and those with good pharmacological adherence (21.19 ±â€Š4.68 vs 28.58 ±â€Š213.79).intellectual quotient was ≥85 in all NBS- and 68.75% of late diagnosis cases evaluated, 15% of which need pedagogical support, and 6.8% (3/44) showed school failure.Among the 12 variants identified in fumarylacetoacetate hydrolase gene, 1 of them novel (H63D), the most prevalent in Spanish population is c.554-1 G>T.After NTBC treatment a reduction in tyrosine and alpha-fetoprotein levels was observed in all the study groups, significant for alpha-fetoprotein in no NBS-group (P = .03), especially in subacute/chronic forms (P = .018).This series confirms that NTBC treatment had clearly improved the prognosis and quality of life of HT1 patients, but it also shows frequent cognitive dysfunctions and learning difficulties in medium-term follow-up, and, in a novel way, a high percentage of overweight/obesity.


Assuntos
Cicloexanonas/uso terapêutico , Diagnóstico Tardio , Nitrobenzoatos/uso terapêutico , Obesidade , Qualidade de Vida , Tirosinemias , Adulto , Criança , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Diagnóstico Tardio/efeitos adversos , Diagnóstico Tardio/prevenção & controle , Inibidores Enzimáticos/uso terapêutico , Feminino , Seguimentos , Humanos , Recém-Nascido , Nefropatias/diagnóstico , Nefropatias/etiologia , Masculino , Determinação de Necessidades de Cuidados de Saúde , Triagem Neonatal/métodos , Obesidade/diagnóstico , Obesidade/etiologia , Prognóstico , Estudos Retrospectivos , Espanha , Tempo para o Tratamento , Tirosinemias/complicações , Tirosinemias/diagnóstico , Tirosinemias/tratamento farmacológico , Tirosinemias/psicologia
13.
Medicine (Baltimore) ; 98(39): e17307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574859

RESUMO

To investigate the cognitive and psychological outcomes of pediatric allogeneic HSCT survivors in China.A total of 135 3 to 18 years old children and adolescents who underwent allo-HSCT and survived at least 3 months post-HSCT were recruited and completed the assessments. Cognitive and psychological functions were assessed via age-appropriate standardized measures. Clinical information was extracted from the medical records.Forty one 3 to 6 years old children completed Psychological Questionnaires for 3 to 6 years Children. The scores of 21(51.2%) children in cognitive development dimension, 18(43.9%) in motor development dimension, 16(39.0%) in language development and social development dimension, 15(36.6%) in emotion and will dimension and 14(34.1%) in living habits dimension were less than the standard. Fifty six 8 to 16 years old children and adolescents completed the Depression Self-rating Scale for Children and 9 (16.1%) of these met the criteria of depression. Sixty nine 7 to 16 years old children and adolescents completed the screening for Child Anxiety Related Disorders and 7 (10.1%) of these met the criteria of anxiety, especially social phobia and school phobia. Eighty nine 6 to 18 years old children and adolescents completed the Symptom Checklist-90 and 43.8% to 77.5% of these experienced mild symptoms like obsession-compulsion (77.5%), hostility (64%), and interpersonal sensitivity (60.7%). Children treated with total body irradiation (TBI) showed more cognitive impairments like motor deficits than those without TBI. Also older children and adolescents had more symptoms like psychoticism.These findings demonstrated cognitive and psychological late effects of pediatric allo-HSCT survivors in a single center in China and highlighted that the survivors conditioned with TBI had more cognitive impairments and older children and adolescents had more symptoms. Early intervention in these children and adolescents might minimize the cognitive losses and psychological effects.


Assuntos
Ansiedade , Disfunção Cognitiva , Depressão , Transplante de Células-Tronco Hematopoéticas , Complicações Pós-Operatórias , Qualidade de Vida , Adolescente , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/prevenção & controle , Criança , Pré-Escolar , China/epidemiologia , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Depressão/diagnóstico , Depressão/etiologia , Depressão/prevenção & controle , Intervenção Médica Precoce/métodos , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Destreza Motora , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Técnicas Psicológicas , Sobreviventes/psicologia
15.
Fisioterapia (Madr., Ed. impr.) ; 41(5): 266-274, sept.-oct. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183936

RESUMO

Antecedentes y objetivo: Las evidencias clínicas indican que los individuos mayores muestran con mayor frecuencia diversos cambios cognoscitivos, siendo leves y poco incapacitantes refiriéndose a las funciones mnésicas y a la rapidez de pensamiento y razonamiento. Numerosas evidencias científicas apoyan el papel del ejercicio físico aeróbico como pilar fundamental para prevenir o retrasar la aparición de deterioro cognitivo leve o demencia. El objetivo de este trabajo consiste en determinar el efecto duradero de la mejoría del estado cognitivo de los adultos mayores sanos a los 6 meses de la finalización de un programa de Revitalización Geriátrica (PRG). Material y métodos: La población de estudio fue tomada de los participantes en el PRG de la Universidad de Salamanca. Siguiendo las directrices de la Organización Mundial de la Salud, los sujetos realizaron 3 sesiones semanales de ejercicio físico moderado durante el periodo de intervención. Para la elección de la muestra se realizó un muestreo aleatorio por conglomerados, donde se eligieron al azar 3 asociaciones del total de asociaciones de la ciudad y en cada una de ellas del conjunto de personas que estaban dispuestas a seguir el PRG. La muestra estaba formada por 35 sujetos de ambos sexos mayores de 60 años. Para la valoración neuropsicológica de los sujetos se incluyeron una serie de pruebas neuropsicológicas validadas: Examen Cognoscitivo Mini-Mental; Test de Retención Visual de Benton; Aprendizaje Audioverbal de Rey; Test de Stroop; Test del Trazo A y B. Resultados: Los resultados nos indican la existencia de diferencias significativas entre las 3 valoraciones realizadas, obteniendo un mayor rendimiento tras la intervención, en las variables evaluadas, y volviendo a puntuaciones iniciales tras la inactividad física. Conclusiones: Se deben encontrar estrategias que limiten el tiempo de inactividad física o de sedentarismo de la población mayor de 65 años, buscando maneras de incentivar a la participación en Programas de Actividad Física


Background and aim: Clinical evidence shows that elder individuals display with greater frequency diverse cognitive changes, minor and slightly incapacitating, related to mnesic functions and speed of thought and reasoning. Much scientific evidence supports the role that aerobic physical activity plays as fundamental to prevent or delay the onset of minor cognitive damage or dementia. The aim of this paper is to determine the lasting effect of improved cognitive status in healthy older adults six months after completing a geriatric revitalization programme (GRP). Material and methods: The study population was recruited among participants in the Universidad de Salamanca GRP. Following the guidelines of the World Health Organization, subjects performed 3 weekly sessions of moderate physical exercise during the intervention period. The sample consisted of 35 subjects of both genders, all of them over 60 years old. For the selection of the sample, random sampling was carried out by conglomerates, where 3 associations of the total number of associations in the city were chosen at random, and in each of the group of people who were willing to follow the GRP. In order to assess the subjects' neuropsychological capacities, a series of validated neuropsychological tests were included: Mini-Mental State Examination; Benton Visual Retention Test; Rey Auditory Verbal Learning Test; Stroop Test; Trail Making Test. Results: The results show significant differences between the three assessments put into effect: after the intervention, performance improved in all variables assessed, and it returned to the initial scores after a period of physical inactivity. Conclusions: We must find strategies to limit spans of physical inactivity or sedentary lifestyles in people over 65 by looking for ways to encourage participation in physical activity programmes


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cognição , Testes de Estado Mental e Demência , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/terapia , Comportamento Sedentário , Exercício , Amostragem por Conglomerados , Neuropsicologia
16.
Prensa méd. argent ; 105(10): 727-735, oct 2019. tab
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1026057

RESUMO

The Amyotrophic Lateral Sclerosis (ALS) is a multisystemic disorder. It is considered a neuromuscular disease but also involves cognitive (executive functions, social cognition, attention, memory and language), emotional or behavior changes in over 50% of the reported cases and to of frontotemporal diagnosis lobar degeneration of behavioral variant in up to 15% of the cases. For this reason, the presence of cognitive and motivational problems was analysed in a Spanish sample of ALS patients through the prefrontal symptoms inventory (PSI) to determine applicability in this disease STI. A sample of 31 patients with a potential ALS or definitive diagnostic criteria according to El Escorial was used. Obtained results ISP were compared with a sample of 31 healthy people in the same proportions of gender, age and education level. Obtained results showed a not significant difference between the two populations in the motivational factor problems, related to the depression symptomatology frequently associated with ALS. A significant positive correlation between age at diagnosis and the scale of the motivational problems was observed, with a not significant trend related to problems in the executive control and in social the behavior control and with the age at diagnosis, in the same sense with age at diagnosis. Therefore, it can be concluded that, despite the results obtained, emotional and behavioral deficits in ALS patients and symptoms related to frontotemporal dementia (among others, anosognosia or lack of consciousness symptoms) could have interfered in patient perception about their symptomatology


Assuntos
Humanos , Masculino , Feminino , Estudos de Casos e Controles , Transtornos Cognitivos , Sintomas Afetivos/diagnóstico , Demência Frontotemporal/diagnóstico , Disfunção Cognitiva/diagnóstico , Esclerose Amiotrófica Lateral , Transtornos Mentais/diagnóstico
17.
Maturitas ; 128: 22-28, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31561818

RESUMO

OBJECTIVE: While exposure to endogenous estrogen may be associated with better cognitive performance, it is still unclear whether it has an association with mild cognitive impairment (MCI) or dementia. The aim of this study was to clarify the effects of reproductive history, as a surrogate marker of exposure to endogenous estrogen, on the risk of cognitive impairment (MCI or dementia) in women. STUDY DESIGN: A total of 747 women aged 40-59 years in the Saku area (Nagano Prefecture) were followed as part of the Japan Public Health Center-based Prospective (JPHC) Study, which started in 1990. Participants had undergone a mental health examination in 2014-2015. MAIN OUTCOME MEASURES: We used multiple logistic regression to analyze the association between reproductive history, obtained at baseline and 10-year follow-up, with current cognitive impairment diagnosed by a trained psychiatrist, adjusting for various lifestyle factors. RESULTS: Among 670 eligible women, current cognitive impairment was diagnosed in 227, 196 of whom had MCI and 31 dementia. A longer reproductive period had a significantly inverse association with cognitive impairment (P-trend = 0.032). In particular, women with a reproductive period ≥38 years compared with ≤33 years had a significantly lower risk of cognitive impairment (multivariable adjusted odds ratio=0.62, 95% confidence interval=0.40-0.96). CONCLUSIONS: A longer reproductive period was associated with a lower risk of cognitive impairment, which suggests that a longer exposure to endogenous estrogen may have a protective effect against cognitive impairment.


Assuntos
Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , História Reprodutiva , Adulto , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/psicologia , Demência/psicologia , Estrogênios , Feminino , Humanos , Japão , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Proteção , Fatores de Risco
18.
Orv Hetil ; 160(38): 1495-1502, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31537098

RESUMO

A significant proportion of cancer patients reports a decline in their usual cognitive functions. This impairment may be the consequence of either the malignant disorder itself or the side-effect of the treatment. This impairment in cognitive skills was referred to with a sticky witty name as chemobrain or chemofog, reflecting on the old conception based on the assumption that solely the neurotoxic effect of chemotherapy was responsible for this kind of disturbances. However, today there is increasing evidence proving that such hypotheses can only partially explain the cognitive decline of cancer patients and cancer survivors. As a matter of fact, the cognitive impairment of cancer patients is a much more complex consequence of the malignant disorder than chemobrain or chemofog. Nowadays, this process is described as "cancer-related cognitive impairment" (CRCI). Orv Hetil. 2019; 160(38): 1495-1502.


Assuntos
Antineoplásicos/efeitos adversos , Transtornos Cognitivos/induzido quimicamente , Disfunção Cognitiva/induzido quimicamente , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Neoplasias/tratamento farmacológico , Antineoplásicos/uso terapêutico , Cognição , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/diagnóstico , Humanos , Neoplasias/complicações
19.
Fortschr Neurol Psychiatr ; 87(9): 504-510, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31519026

RESUMO

BACKGROUND: Neuropsychological dementia diagnosis of migrants are limited regarding the testing of cognitive abilities as well as the recording of everyday activities (Activities of Daily Living, ADL) such as linguistic, educational, lifestyle and cultural-religious factors have not been taken into account in psychometric instruments. AIM OF THE STUDY: We aimed to develop a culturally sensitive ADL scale, which is suitable for both German people and Turkish migrants that takes into consideration gender, cultural-religious and lifestyle aspects. A further aim was to determine the quality criteria for the newly proposed ADL scale. METHODS: After the initial phase, including qualitative interviews (N = 15) with cognitively unimpaired German participants and Turkish migrants, a first version of the ADL instrument was developed. This version was then completed by cognitively unimpaired Germans (n = 197) and Turkish participants (n = 53) and the shortened ADL scale was generated based on an item analysis. It consisted of the three subscales 'cognition', 'Basic Activities of Daily Living (BADL)' and 'Instrumental Activities of Daily Living (IADL)'. For Turkish participants, questions about Islamic prayers were added. Montreal Cognitive Assessment (MoCA) and Geriatric Depression Scale (GDS) were applied to rule out cognitive impairment and depression. The 'Bayer-ADL' was used to measure the validity of the scale. RESULTS: The everyday life of Germans and Turkish migrants differs in aspects of religious practice and in terms of sociocultural activities, which are taken into account in the CC-ADL. The reliability of the new ADL scale in terms of internal consistency (Cronbach's alpha) were regarding 'cognition' α = .43 for Germans and α = .80 for Turkish migrants; 'BADL' α = .55 for Germans and α = -.04 for Turkish migrants; 'IADL' α = .91 for Germans and α = .83 for Turkish migrants and α = .73 for Turkish migrants under the 'prayer items'. The correlation of the ADL total score with the Bayer ADL for Germans was ρ = .347 (p < .00) and for the Turkish sample ρ = .520 (p < .01). CONCLUSION: The development of a final version of the CC-ADL scale requires further data from healthy participants and patients (Mild Cognitive Impairment and dementia).


Assuntos
Atividades Cotidianas , Competência Cultural , Demência/diagnóstico , Demência/psicologia , Emigrantes e Imigrantes/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Feminino , Alemanha , Humanos , Estilo de Vida/etnologia , Masculino , Testes Neuropsicológicos , Religião e Psicologia , Reprodutibilidade dos Testes , Turquia/etnologia
20.
Psychiatr Danub ; 31(Suppl 3): 261-264, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488738

RESUMO

BACKGROUND: Schizophrenia can be interpreted as a pathology involving the neocortex whose cognitive dysfunctions represent a central and persistent characteristic of the disease, as well as one of the more important symptoms in relation to the impairment of psychosocial functioning and the resulting disabilities. Given the implication of cognitive functions in everyday life, they can better predict the degree of schizophrenia. The study proposes to use Machine Learning techniques to identify the specific cognitive deficits of schizophrenia that mostly characterize the disorder, as well as to develop a predictive system that can diagnose the presence of schizophrenia based on neurocognitive tests. BACKGROUND: The study employs a dataset of neurocognitive assessments carried out on 201 people (86 schizophrenic patients and 115 healthy patients) recruited by the Neuroscience Group of the University of Bari "A. Moro". A data analysis process has been carried out, with the aim of selecting the most relevant features as well as to prepare data for training a number of "off-the-shelf" machine learning methods (Decision Tree, Random Forest, Logistic Regression, k-Nearest Neighbor, Neural Network, Support Vector Machine), which have been evaluated in terms of classification accuracy according to stratified 20-fold cross-validation. RESULTS: Among all variables, 14 were selected as the most influential for the classification problem. The variables with greater influence are related to working memory, executive functions, attention, verbal fluency, memory. The best algorithms turned out to be Support Vector Machine (SVM) and Neural Network, showing an accuracy of 87.8% and 84.8% on a test set. CONCLUSIONS: Machine Learning provides "cheap" and non-invasive methods that potentially enable early intervention with specific rehabilitation interventions. The results suggest the need to integrate a thorough neuropsychological evaluation into the more general diagnostic evaluation of patients with schizophrenia disorder.


Assuntos
Transtornos Cognitivos/complicações , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/complicações , Disfunção Cognitiva/diagnóstico , Aprendizado de Máquina , Esquizofrenia/complicações , Esquizofrenia/diagnóstico , Cognição , Humanos , Testes Neuropsicológicos , Psicologia do Esquizofrênico
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