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1.
Medicine (Baltimore) ; 100(24): e26365, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128891

RESUMO

BACKGROUND: Multiple clinical trials have demonstrated the safety and efficacy of erythropoietin in improving neurodevelopmental outcomes in infants with hypoxic-ischemic encephalopathy (HIE). It is undoubtedly urgent to include only randomized controlled trials (RCTs) for more standardized systematic reviews and meta-analyses. The purpose of this study is to examine whether erythropoietin reduces the risk of death and improve neurodevelopmental disorders in infants with HIE. METHODS: The electronic databases of Cochrane Library, EMBASE, PubMed, and Web of Science were searched from the inception to June 2021 using the following key terms: "erythropoietin," "hypoxic-ischemic encephalopathy," and "prospective," for all relevant RCTs. Only English publications were included. The primary outcome was mortality rate. Secondary outcomes included neurodevelopmental disorders, brain injury, and cognitive impairment. The Cochrane risk of bias tool was independently used to evaluate the risk of bias of included RCTs by 2 reviewers. RESULTS: We hypothesized that group with erythropoietin would provide better therapeutic benefits compared with control group. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/FERUS.


Assuntos
Eritropoetina/uso terapêutico , Hipóxia-Isquemia Encefálica/tratamento farmacológico , Metanálise como Assunto , Revisões Sistemáticas como Assunto , Protocolos Clínicos , Disfunção Cognitiva/prevenção & controle , Eritropoetina/efeitos adversos , Humanos , Hipóxia-Isquemia Encefálica/complicações , Hipóxia-Isquemia Encefálica/mortalidade , Lactente , Transtornos do Neurodesenvolvimento/prevenção & controle , Fatores de Risco , Resultado do Tratamento
2.
Dement Geriatr Cogn Disord ; 50(1): 85-95, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34126622

RESUMO

INTRODUCTION: It is well-known that cognitive function declines with age. In order to detect changes in cognitive function, cognitive tests should be performed repeatedly. Currently existing cognitive tests come in only a single version, so the subject is likely to remember the contents with repeated testing. And, under the outbreak of coronavirus disease 2019 (COVID-19), in-person assessment should be avoided. This study was performed to develop a new cognitive test (brain assessment, BA) that has 5 versions and can be performed on a personal computer (PC) through the Internet. MATERIALS AND METHODS: Five thousand subjects performed the online BA, which consisted of 5 subtests: number memory, word memory, mental rotation test, N-back test, and judgment test. We standardized the raw scores (cognitive scores, CSs) using mean and standard deviation, which were 50 and 10, respectively. Then, we calculated the mean CS for each sex and age, plotted the relationships between ages and mean CSs on figures, and calculated the formula of cognitive changes during normal aging. RESULTS: The CSs of all subtests decreased with aging. The regression coefficient was from -0.31 to -0.45. It is noteworthy that in most subtests, the CSs started to increase at 85 years of age. DISCUSSION: Our BA has 5 versions and can be done on a PC using the Internet. We tested the BA in a large number of subjects, and the standard values of CSs were measured in individuals up to 89 years of age. By performing this test repeatedly, subjects can evaluate the degree of their cognitive decline. If the rate of cognitive decline is greater than that predicted using the normalized formula, the subjects can undertake strategies to improve their control of lifestyle-related diseases or other habits of daily living. CONCLUSION: The BA can be easily taken online using a PC, and its scores linearly declined with normal aging. The BA will be useful for detecting longitudinal cognitive changes and comparing them to the pattern seen in normal aging.


Assuntos
Envelhecimento/psicologia , Cognição , Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/prevenção & controle , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade
3.
BMC Geriatr ; 21(1): 367, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34134667

RESUMO

BACKGROUND: The irreversibility of cognitive impairment of Alzheimer's disease (AD) prompts that preventing or delaying the onset of AD should be a public health priority. Vitamin B supplements can lower the serum homocysteine (Hcy) level, but whether it can prevent cognitive decline or not remains unclear. We aimed to evaluate the preventive efficacy of vitamin B supplements on the cognitive decline of elderly adults. METHODS: We searched PubMed, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, Science Direct, PsycINFO from inception to December 1, 2019, and then updated the retrieved results on June 1, 2020. The randomized controlled trials (RCTs) which evaluated the efficacy of vitamin B in mild cognitive impairment (MCI) patients or elderly adults without cognitive impairment were selected. Standardized mean difference (SMD) or mean difference (MD) as well as their 95 % confidence interval (CI) were calculated by performing random effects models or fixed effects models. RESULTS: A total of 21 RCTs involving 7571 participants were included for meta-analysis. The forest plots showed that there is significant effect in global cognitive function (15 RCTs, SMD: 0.36; 95 % CI: 0.18 to 0.54, P < 0.01) and Hcy (11 RCTs, MD: -4.59; 95 %CI: -5.51 to -3.67, P < 0.01), but there is no effect in information processing speed (10 RCTs, SMD: 0.06; 95 % CI: -0.12 to 0.25, P = 0.49), episodic memory (15 RCTs, SMD: 0.10; 95 % CI: -0.04 to 0.25, P = 0.16), executive function (11 RCTs, SMD: -0.21; 95 % CI: -0.49 to 0.06, P = 0.13). The value of effect size and heterogeneity did not vary apparently when excluding the low-quality studies, so we could believe that the results of meta-analysis were robust. CONCLUSIONS: Vitamin B supplements might delay or maintain the cognitive decline of elderly adults. We can recommend that the vitamin B supplements should be considered as a preventive medication to MCI patients or elderly adults without cognitive impairment. More well-designed RCTs with large sample sizes were required to clarify the preventive efficacy in the future.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Idoso , Cognição , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/prevenção & controle , Suplementos Nutricionais , Humanos , Vitaminas
4.
J Int Med Res ; 49(5): 3000605211014294, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33983077

RESUMO

OBJECTIVE: Senile patients often experience neurocognitive disturbance after non-cardiac surgery. Several clinical trials have investigated if the perioperative intravenous use of dexmedetomidine has a positive effect on the prevention of neurocognitive dysfunction, but the results have been inconsistent. We performed a meta-analysis to investigate the effects of dexmedetomidine on neurocognitive disturbance after elective non-cardiac surgery in senile patients. METHODS: The PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure databases were comprehensively searched for all randomized controlled trials published before 1 February 2020 that investigated the efficacy of dexmedetomidine in the prevention of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD). RESULTS: Sixteen studies involving 4376 patients were included in this meta-analysis. Compared with the control (i.e., saline), the perioperative intravenous use of dexmedetomidine significantly reduced the incidence of POD and POCD. However, patients in the dexmedetomidine group were more likely to develop bradycardia and hypotension during the administration of dexmedetomidine than patients in the control group. There were no differences between the two groups in the incidence of nausea and vomiting or mortality rate. CONCLUSION: Dexmedetomidine has a positive effect on the prevention of neurocognitive disturbance in senile patients after elective non-cardiac surgery.


Assuntos
Disfunção Cognitiva , Delírio , Dexmedetomidina , Hipotensão , China , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/prevenção & controle , Dexmedetomidina/uso terapêutico , Humanos , Complicações Pós-Operatórias/prevenção & controle
5.
Maturitas ; 148: 7-13, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34024351

RESUMO

OBJECTIVES: . We used longitudinal cohort data to examine the effect of leisure activities and psychological wellbeing on the risk of cognitive impairment among Chinese older adults with hearing difficulty (HD). STUDY DESIGN: . This prospective cohort study included 10,341 cognitively normal individuals aged 65 years or more at baseline from the Chinese Longitudinal Healthy Longevity survey (from 2002 to 2011). MAIN OUTCOME MEASURES: . Hearing difficulty, leisure activities and psychological wellbeing were measured at baseline. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as an MMSE score of less than 18 points. RESULTS: . During a median follow-up of 5.6 years (59,869 person-years), 2,614 participants developed cognitive impairment. Cox proportional hazards models showed that the multi-adjusted hazard ratio (HR, 95% confidence interval) of cognitive impairment was 1.42 (1.28-1.58) for HD. Participants with a healthy lifestyle had a lower risk of cognitive impairment (HR = 0.77, 95% CI 0.69-0.85). Furthermore, participants with HD and a healthy lifestyle (HR = 1.67, 95% CI 1.27-2.18) had a lower HR of cognitive impairment than those with HD and an unhealthy lifestyle (HR = 1.86, 95% CI 1.61-2.14). A healthy lifestyle also delayed the onset of cognitive impairment by 0.50 years in people with HD. CONCLUSIONS: . HD was associated with an increased risk of cognitive impairment, but a healthy lifestyle may decrease the risk of cognitive impairment related to HD and delay the onset of cognitive impairment.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Disfunção Cognitiva/prevenção & controle , Perda Auditiva/complicações , Atividades de Lazer , Saúde Mental , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , China , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/patologia , Feminino , Nível de Saúde , Humanos , Longevidade , Estudos Longitudinais , Masculino , Testes de Estado Mental e Demência , Estudos Prospectivos
7.
Medicine (Baltimore) ; 100(16): e25535, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879696

RESUMO

OBJECTIVE: The effect of probiotics on cognitive function and the risk of falling in cirrhosis patients have not been previously evaluated. We perform this protocol for systematic review and meta-analysis to evaluate the effect of a multistrain probiotic on cognitive function and the risk of falls in patients with cirrhosis. METHODS: An all-round retrieval will be performed in 5 electronic journal databases from their inception to March 2021, which comprise Medline, Pubmed, Embase, ScienceDirect, and the Cochrane Library by 2 independent reviewers. Data extraction was performed independently, and any conflict was resolved before final analysis. Only randomized clinical trials were included in this study. The main endpoints were cognitive function and risk of falls, and the secondary endpoints were fall incidence, health-related quality of life (HRQOL), systemic inflammatory response, gut barrier, bacterial translocation, and fecal microbiota. The risk of bias assessment of the included studies was performed by 2 authors independently using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: We hypothesized that the multistrain probiotic improved cognitive function, risk of falls, and inflammatory response in patients with cirrhosis and cognitive dysfunction. CONCLUSION: This study expects to provide credible and scientific clinical evidence for the efficacy and safety of a multistrain probiotic on cognitive function and the risk of falls in patients with cirrhosis. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/JKMTP.


Assuntos
Acidentes por Quedas/prevenção & controle , Disfunção Cognitiva/prevenção & controle , Cirrose Hepática/psicologia , Cirrose Hepática/terapia , Probióticos/uso terapêutico , Cognição , Disfunção Cognitiva/microbiologia , Feminino , Humanos , Cirrose Hepática/microbiologia , Masculino , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Fatores de Risco , Revisões Sistemáticas como Assunto , Resultado do Tratamento
8.
Int J Mol Sci ; 22(9)2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33925430

RESUMO

Although ionizing radiation (radiation) is commonly used for medical diagnosis and cancer treatment, radiation-induced damages cannot be avoided. Such damages can be classified into direct and indirect damages, caused by the direct absorption of radiation energy into DNA and by free radicals, such as hydroxyl radicals (•OH), generated in the process of water radiolysis. More specifically, radiation damage concerns not only direct damages to DNA, but also secondary damages to non-DNA targets, because low-dose radiation damage is mainly caused by these indirect effects. Molecular hydrogen (H2) has the potential to be a radioprotective agent because it can selectively scavenge •OH, a reactive oxygen species with strong oxidizing power. Animal experiments and clinical trials have reported that H2 exhibits a highly safe radioprotective effect. This paper reviews previously reported radioprotective effects of H2 and discusses the mechanisms of H2, not only as an antioxidant, but also in intracellular responses including anti-inflammation, anti-apoptosis, and the regulation of gene expression. In doing so, we demonstrate the prospects of H2 as a novel and clinically applicable radioprotective agent.


Assuntos
Hidrogênio/farmacologia , Neoplasias/terapia , Lesões por Radiação/prevenção & controle , Protetores contra Radiação/farmacologia , Animais , Antioxidantes/farmacologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Gastroenteropatias/etiologia , Gastroenteropatias/prevenção & controle , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos da radiação , Humanos , Hidrogênio/uso terapêutico , Sistema Imunitário/efeitos dos fármacos , Sistema Imunitário/efeitos da radiação , Masculino , Qualidade de Vida , Protetores contra Radiação/uso terapêutico , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Espermatozoides/efeitos dos fármacos , Espermatozoides/efeitos da radiação
9.
Nutrients ; 13(4)2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33919810

RESUMO

Although l-carnitine alleviated white-matter lesions in an experimental study, the treatment effects of l-carnitine on white-matter microstructural damage and cognitive decline in hemodialysis patients are unknown. Using novel diffusion magnetic resonance imaging (dMRI) techniques, white-matter microstructural changes together with cognitive decline in hemodialysis patients and the effects of l-carnitine on such disorders were investigated. Fourteen hemodialysis patients underwent dMRI and laboratory and neuropsychological tests, which were compared across seven patients each in two groups according to duration of l-carnitine treatment: (1) no or short-term l-carnitine treatment (NSTLC), and (2) long-term l-carnitine treatment (LTLC). Ten age- and sex-matched controls were enrolled. Compared to controls, microstructural disorders of white matter were widely detected on dMRI of patients. An autopsy study of one patient in the NSTLC group showed rarefaction of myelinated fibers in white matter. With LTLC, microstructural damage on dMRI was alleviated along with lower levels of high-sensitivity C-reactive protein and substantial increases in carnitine levels. The LTLC group showed better achievement on trail making test A, which was correlated with amelioration of disorders in some white-matter tracts. Novel dMRI tractography detected abnormalities of white-matter tracts after hemodialysis. Long-term treatment with l-carnitine might alleviate white-matter microstructural damage and cognitive impairment in hemodialysis patients.


Assuntos
Carnitina/administração & dosagem , Disfunção Cognitiva/prevenção & controle , Demência Vascular/prevenção & controle , Falência Renal Crônica/terapia , Fármacos Neuroprotetores/administração & dosagem , Diálise Renal/efeitos adversos , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Estudos Transversais , Demência Vascular/diagnóstico , Demência Vascular/etiologia , Demência Vascular/patologia , Imagem de Tensor de Difusão , Esquema de Medicação , Feminino , Humanos , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de Tempo , Resultado do Tratamento , Substância Branca/diagnóstico por imagem , Substância Branca/efeitos dos fármacos , Substância Branca/patologia
10.
Asian J Psychiatr ; 60: 102646, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33873045

RESUMO

BACKGROUND: The effects of aging and its associated cognitive decline is particularly acute in Asia given the exponential growth of older adults as a proportion of the population as a whole. Many structured cognitive interventions have been proposed to prevent the cognitive decline typically seen in older age, but their utility as a viable means of achieving these goals is questionable. OBJECTIVES: To summarize and synthesize evidence on the utility and methodological quality of cognitive-based interventions on cognitive performance and associated secondary outcomes among healthy older adults in Asia, as well as novel, culture-specific components of cognitive interventions across the region. DATA SOURCES: The PubMed/Medline, Web of Science, Scopus, and ScienceDirect databases were searched through May 2020. ELIGIBILITY: Studies including individuals aged 60 years and above, who had no previous history of physical and/or mental illness. Few restrictions placed on intervention design, duration and mode of delivery, provided that participants were randomized to study conditions, and intervention included components addressing at least one cognitive domain. RESULTS: A total of 17 studies from six countries met the eligibility criteria and were included in the final review. Evidence from those studies indicated that cognitive interventions may be most effective when the design and aims were directed towards improvement in specific cognitive domains, but evidence regarding long-term effectiveness in preventing progression to clinical-level cognitive deficits is still unclear. Several studies highlighted culture-specific activities as components of their interventions, though these will need to be further outlined and standardized clearly in future research.


Assuntos
Disfunção Cognitiva , Idoso , Ásia , Cognição , Disfunção Cognitiva/prevenção & controle , Nível de Saúde , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Neurology ; 96(19): e2429-e2437, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33790041

RESUMO

OBJECTIVE: To determine whether greater physical activity could modify the negative association of APOE ε4 with longitudinal cognitive changes in early Parkinson disease (PD) and to uncover the disease-specific mechanism for explaining such benefits of physical activity. METHODS: We used data from the Parkinson's Progression Markers Initiative cohort. Because self-reported physical activity, measured by the Physical Activity Scale of the Elderly, was initiated at 2 years after enrollment, this longitudinal analysis was based on assessments performed at years 2, 3, and 4. Cognitive function was measured annually with the Montreal Cognitive Assessment (MoCA). Dopamine transporter (DAT) imaging was performed at years 2 and 4. We assessed the interactive associations between physical activity and the APOE ε4 allele on the longitudinal changes in MoCA scores and striatal DAT activities. RESULTS: A total of 173 patients with early PD (age 63.3 ± 10.0 years, 27% APOE ε4 carriers) were included. The APOE ε4 allele showed a steeper rate of cognitive decline than the non-APOE ε4 allele (estimate -1.33, 95% confidence interval [CI] -2.12 to -0.47, p = 0.002). However, there was a significant interaction between physical activity and APOE ε4 such that higher physical activity was related to slower APOE ε4-related cognitive decline (estimate 0.007, 95% CI 0.003-0.011, p = 0.001). No significant interaction was found between physical activity and the APOE ε4 allele regarding the change in striatal DAT activities. CONCLUSION: Increased physical activity attenuated APOE ε4-related vulnerability to early cognitive decline in patients with PD. This protective effect did not appear to be mediated by striatal dopaminergic function. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov Identifier: NCT01141023. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that increased physical activity was associated with decreased APOE ε4-related early cognitive decline in patients with PD.


Assuntos
Apolipoproteína E4/genética , Disfunção Cognitiva/genética , Disfunção Cognitiva/psicologia , Exercício Físico/psicologia , Doença de Parkinson/genética , Doença de Parkinson/psicologia , Idoso , Disfunção Cognitiva/prevenção & controle , Estudos de Coortes , Exercício Físico/fisiologia , Feminino , Genótipo , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/terapia
12.
Artigo em Russo | MEDLINE | ID: mdl-33834731

RESUMO

Cognitive impairment (CI) develops not only in structural damage to the central nervous system, but also in encephalopathies of dysmetabolic and deficiency etiology. Recently, special attention is focused on the appearance of CI due to the deficiency of cobalamin (vitamin B12) and folic acid (FA), the change in the level of homocysteine (HC). To detect vitamin B12 deficiency is possible by examining key biomarkers in serum based on a decrease in the levels of vitamin B12 and holotranscobalamin, and levels of methylmalonic acid (MMA) and HC. The article presents an analysis of studies conducted in Norway, Korea, India, and other countries to assess the risks of CI in the presence of reduced levels of vitamin B12 in the elderly, which demonstrated a decrease in brain volume in the elderly (according to MRI data) in combination with altered test parameters that assess cognitive functions. In many studies, female patients with reduced levels of vitamin B12 predominated among the studied patients. Also, some studies have demonstrated the effectiveness of complex CI therapy with the inclusion of vitamin B12 (both for oral and intravenous administration). Oral vitamin B12 therapy at a dose of 1000 µg has been shown to be adequate for the treatment of vitamin B12 deficiency. Also, the administration of vitamin B12 for prophylactic purposes is recommended for patients with subnormal or borderline concentrations of vitamin B12 in the blood serum.


Assuntos
Disfunção Cognitiva , Deficiência de Vitamina B 12 , Idoso , Biomarcadores , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Feminino , Ácido Fólico , Humanos , Ácido Metilmalônico , Vitamina B 12 , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/tratamento farmacológico
13.
Artigo em Inglês | MEDLINE | ID: mdl-33808633

RESUMO

Previous studies indicated that Tai Chi might be an effective way to improve or prevent cognitive impairments in older populations. However, existing research does not provide clear recommendations about the optimal dose of Tai Chi practice, which is the most effective in improving cognitive function in older adults. The purpose of this systematic review and meta-analysis was to investigate the dose-response relationship between Tai Chi and cognition in community-dwelling older adults. A total of 16 studies with 1121 subjects were included in this study. Meta-regression analyses of Tai Chi duration (Tai Chi session duration, Tai Chi practice duration per week, study duration, and Tai Chi practice duration for the entire study) on the study effect size (ES) were performed to examine the dose-response association of Tai Chi and cognition. The results showed that there was a positive effect of Tai Chi on cognitive function, but there were no statistically significant dose duration effects on cognition. The findings suggest that Tai Chi has beneficial effects on cognitive function, but a longer duration was not associated with larger effects. In order to establish evidence-based clinical interventions using Tai Chi, future research should clearly demonstrate intervention protocol, particularly the style and intensity of Tai Chi.


Assuntos
Disfunção Cognitiva , Tai Ji , Idoso , Cognição , Disfunção Cognitiva/prevenção & controle , Humanos , Vida Independente , Fatores de Tempo
14.
Int J Mol Sci ; 22(5)2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33802413

RESUMO

Neonatal hypoxia-ischemia (HI) is a brain injury caused by oxygen deprivation to the brain due to birth asphyxia or reduced cerebral blood perfusion, and it often leads to lifelong limiting sequelae such as cerebral palsy, seizures, or mental retardation. HI remains one of the leading causes of neonatal mortality and morbidity worldwide, and current therapies are limited. Hypothermia has been successful in reducing mortality and some disabilities, but it is only applied to a subset of newborns that meet strict inclusion criteria. Given the unpredictable nature of the obstetric complications that contribute to neonatal HI, prophylactic treatments that prevent, rather than rescue, HI brain injury are emerging as a therapeutic alternative. Nutraceuticals are natural compounds present in the diet or used as dietary supplements that have antioxidant, anti-inflammatory, or antiapoptotic properties. This review summarizes the preclinical in vivo studies, mostly conducted on rodent models, that have investigated the neuroprotective properties of nutraceuticals in preventing and reducing HI-induced brain damage and cognitive impairments. The natural products reviewed include polyphenols, omega-3 fatty acids, vitamins, plant-derived compounds (tanshinones, sulforaphane, and capsaicin), and endogenous compounds (melatonin, carnitine, creatine, and lactate). These nutraceuticals were administered before the damage occurred, either to the mothers as a dietary supplement during pregnancy and/or lactation or to the pups prior to HI induction. To date, very few of these nutritional interventions have been investigated in humans, but we refer to those that have been successful in reducing ischemic stroke in adults. Overall, there is a robust body of preclinical evidence that supports the neuroprotective properties of nutraceuticals, and these may represent a safe and inexpensive nutritional strategy for the prevention of neonatal HI encephalopathy.


Assuntos
Encéfalo/efeitos dos fármacos , Hipóxia-Isquemia Encefálica/prevenção & controle , Neuroproteção/efeitos dos fármacos , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico , Animais , Animais Recém-Nascidos , Disfunção Cognitiva/prevenção & controle , Suplementos Nutricionais , Humanos
15.
Nutrients ; 13(4)2021 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-33800577

RESUMO

Nowadays, it is accepted that the regular practice of exercise and branched-chain amino acids supplementation (BCAAs) can benefit the immune responses in older persons, prevent the occurrence of physical frailty (PF), cognitive decline, and aging-related comorbidities. However, the impact of their combination (as non-pharmacological interventions) in albumin and the inflammatory markers is not fully understood. Therefore, we investigated the effect of a 40-week multifactorial intervention [MIP, multicomponent exercise (ME) associated or not with BCAAs] on plasma levels of inflammatory markers and albumin in frail older persons (≥75 years old) living at residential care homes (RCH). This study consisted of a prospective, naturalistic, controlled clinical trial with four arms of multifactorial and experimental (interventions-wahshout-interventions) design. The intervention groups were ME + BCAAs (n = 8), ME (n = 7), BCAAs (n = 7), and control group (n = 13). Lower limb muscle-strength, cognitive profile, and PF tests were concomitantly evaluated with plasma levels of albumin, anti- and pro-inflammatory cytokines [Interleukin-10 (IL-10) and Tumor Necrosis Factor-alpha (TNF-α) respectively], TNF-α/IL-10 ratio, and myeloperoxidase (MPO) activity at four different time-points: Baseline (T1), after 16 weeks of multifactorial intervention (T2), then after a subsequent 8 weeks washout period (T3) and finally, after an additional 16 weeks of multifactorial intervention (T4). Improvement of cognitive profile and muscle strength-related albumin levels, as well as reduction in the TNF-α levels were found particularly in ME plus BCAAs group. No significant variations were observed over time for TNF-α/IL-10 ratio or MPO activity. Overall, the study showed that MIP triggered slight alterations in the inflammatory and physical function of the frail older participants, which could provide independence and higher quality of life for this population.


Assuntos
Aminoácidos de Cadeia Ramificada/administração & dosagem , Suplementos Nutricionais , Terapia por Exercício/métodos , Fragilidade/prevenção & controle , Albumina Sérica/metabolismo , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Biomarcadores/sangue , Cognição/fisiologia , Disfunção Cognitiva/prevenção & controle , Citocinas/sangue , Feminino , Idoso Fragilizado , Avaliação Geriátrica , Humanos , Masculino , Força Muscular/fisiologia , Peroxidase/sangue , Ensaios Clínicos Pragmáticos como Assunto , Estudos Prospectivos , Qualidade de Vida
16.
J Pak Med Assoc ; 71(Suppl 2)(2): S10-S13, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33785934

RESUMO

OBJECTIVE: This study aimed to evaluate the relationship between Post-operative Cognitive Dysfunction (POCD) and regional Oxygen saturation (rSOs) determined by NIRS monitoring during Open-heart surgery. Methods: This was a prospective cohort study of all patients about to undergo Open-heart surgery at Cipto Mangunkusumo National Referral Hospital, Jakarta. Subjects who fulfilled the selection criteria underwent cognitive assessment one day before the surgery. Basal rSO2 was registered prior to anaesthetic induction, and this value was reported every 10 minutes throughout the procedure as the lowest rSO2 and total desaturation (drop >20%) duration. On postoperative day 5, cognitive function was reassessed. We declared a drop in the cognitive function if the score dropped to >20% from the baseline in at least two cognitive tests. RESULTS: The incidence of POCD was 51.7%. Basal rSO2 values between POCD and non-POCD subjects were relatively similar. A significant difference was noted in the duration of total rSO2 desaturation between the two groups. Total rSO2 desaturation was longer in subjects with than without POCD. The ROC (receiver operating characteristic) curve showed a cut-off point of 20.5 minutes, with an AUC (area under curve) size of 126.5 minutes %. CONCLUSIONS: Absolute rSO2 values did not correlate with POCD. However, a drop in rSO2 value >20% from baseline may correlate with POCD. The use of NIRS in Open-heart surgery may, be beneficial for POCD prevention.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Disfunção Cognitiva , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cognição , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Humanos , Oximetria , Estudos Prospectivos , Espectroscopia de Luz Próxima ao Infravermelho
17.
FASEB J ; 35(4): e21485, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33709562

RESUMO

Cognitive dysfunction often occurs in diabetes mellitus patients. This study aimed to investigate the efficacy of melatonin (MLT) in improving diabetes-associated cognitive decline and the underlying mechanism involved. Type 2 diabetic mice and palmitic acid (PA)-stimulated BV-2 cells were treated by MLT, and the potential mechanisms among MLT, cognition, and autophagy were explored. The results showed that type 2 diabetic mice showed obvious learning and memory impairments in the Morris water maze test compared with normal controls, which could be ameliorated by MLT treatment. Meanwhile, MLT administration significantly improved neuroinflammation and regulated microglial apoptosis. Furthermore, autophagy inhibitor 3-methyladenine (3-MA) increased the microglial inflammation and apoptosis, indicating that the treatment effect of MLT was mediated by autophagy. Lastly, MLT treatment significantly decreased the levels of toll-like receptors 4 (TLR4), phosphorylated-protein kinase B (Akt), and phosphorylated-mechanistic target of rapamycin (mTOR), indicating that blocking TLR4/Akt/mTOR pathway might be an underlying basis for the anti-inflammatory and anti-apoptosis effects of MLT. Collectively, our study suggested that MLT could improve learning and memory in type 2 diabetic mice by activating autophagy via the TLR4/Akt/mTOR pathway, thereby inhibiting neuroinflammation and microglial apoptosis.


Assuntos
Disfunção Cognitiva/prevenção & controle , Melatonina/farmacologia , Microglia/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/efeitos dos fármacos , Animais , Anti-Inflamatórios/farmacologia , Disfunção Cognitiva/metabolismo , Diabetes Mellitus Experimental/metabolismo , Inflamação/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Microglia/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , Serina-Treonina Quinases TOR/efeitos dos fármacos
18.
Mar Drugs ; 19(3)2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33673531

RESUMO

To evaluate the effects of Ecklonia cava (E. cava) on ambient-pollution-induced neurotoxicity, we used a mouse model exposed to particulate matter smaller than 2.5 µm in aerodynamic diameter (PM2.5). The intake of water extract from E. cava (WEE) effectively prevented the learning and memory decline. After a behavioral test, the toll-like receptor (TLR)-4-initiated inflammatory response was confirmed by PM2.5 exposure in the lung and brain tissues, and the WEE was regulated through the inhibition of nuclear factor-kappa B (NF-κB)/inflammasome formation signaling pathway and pro-inflammatory cytokines (IL-6 and IFN-γ). The WEE also effectively improved the PM2.5-induced oxidative damage of the lungs and brain through the inhibition of malondialdehyde (MDA) production and the activation of mitochondrial activity (mitochondrial ROS content, mitochondria membrane potential (MMP), adenosine triphosphate (ATP) content, and mitochondria-mediated apoptotic molecules). In particular, the WEE regulated the cognition-related proteins (a decreased amyloid precursor protein (APP) and p-Tau, and an increased brain-derived neurotrophic factor (BDNF)) associated with PM2.5-induced cognitive dysfunction. Additionally, the WEE prevented the inactivation of acetylcholine (ACh) synthesis and release as a neurotransmitter by regulating the acetylcholinesterase (AChE) activity, choline acetyltransferase (ChAT), and ACh receptor (AChR)-α3 in the brain tissue. The bioactive compounds of the WEE were detected as the polysaccharide (average Mw; 160.13 kDa) and phenolic compounds including 2'-phloroeckol.


Assuntos
Disfunção Cognitiva/prevenção & controle , Síndromes Neurotóxicas/prevenção & controle , Material Particulado/toxicidade , Feófitas/química , Animais , Anti-Inflamatórios/isolamento & purificação , Anti-Inflamatórios/farmacologia , Comportamento Animal/efeitos dos fármacos , Disfunção Cognitiva/etiologia , Inflamassomos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Mitocôndrias/efeitos dos fármacos , NF-kappa B/metabolismo , Síndromes Neurotóxicas/etiologia , Estresse Oxidativo/efeitos dos fármacos
19.
Mayo Clin Proc ; 96(3): 788-814, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33673927

RESUMO

Increased life expectancy combined with the aging baby boomer generation has resulted in an unprecedented global expansion of the elderly population. The growing population of older adults and increased rate of age-related chronic illness has caused a substantial socioeconomic burden. The gradual and progressive age-related decline in hormone production and action has a detrimental impact on human health by increasing risk for chronic disease and reducing life span. This article reviews the age-related decline in hormone production, as well as age-related biochemical and body composition changes that reduce the bioavailability and actions of some hormones. The impact of hormonal changes on various chronic conditions including frailty, diabetes, cardiovascular disease, and dementia are also discussed. Hormone replacement therapy has been attempted in many clinical trials to reverse and/or prevent the hormonal decline in aging to combat the progression of age-related diseases. Unfortunately, hormone replacement therapy is not a panacea, as it often results in various adverse events that outweigh its potential health benefits. Therefore, except in some specific individual cases, hormone replacement is not recommended. Rather, positive lifestyle modifications such as regular aerobic and resistance exercise programs and/or healthy calorically restricted diet can favorably affect endocrine and metabolic functions and act as countermeasures to various age-related diseases. We provide a critical review of the available data and offer recommendations that hopefully will form the groundwork for physicians/scientists to develop and optimize new endocrine-targeted therapies and lifestyle modifications that can better address age-related decline in heath.


Assuntos
Envelhecimento Cognitivo/fisiologia , Disfunção Cognitiva/prevenção & controle , Envelhecimento Saudável/fisiologia , Terapia de Reposição Hormonal/estatística & dados numéricos , Estilo de Vida , Idoso , Terapia Comportamental/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo
20.
Acta Biochim Biophys Sin (Shanghai) ; 53(4): 419-429, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33637986

RESUMO

Neuroinflammation and cognitive decline are the key pathological features in aging that bring detrimental impacts upon quality of life. However, there is no effective anti-aging pharmacological therapy thus far. Dietary supplements in particular essence of chicken (EC) has been found to be an effective remedy for alleviating mental stress and improving memory. In addition, a novel hydrolyzed chicken extract, ProBeptigen/CMI-168 (PB), showed beneficial effects on cognitive ability. However, the antiaging effect and possible mechanism of PB and EC are still unknown. Here, we investigated the antiaging effects of PB and EC on hippocampus-related cognitive decline and neuroinflammation in aged mice. PB and EC were administered for 16 weeks in 10-month-old mice. Both PB and EC treatments ameliorated age-related deterioration of learning and memory, and attenuated oxidative stress and inflammation in the hippocampus. These results were associated with decreased inflammatory cytokine levels and increased neurotransmitter levels in the hippocampus. The overall effects of improving aging-induced cognitive decline were more robust in PB-treated mice, while EC was effective in decreasing oxidative stress and inflammation. Moreover, alterations in the diversity and composition of the gut microbiota in aged mice were also regulated by both PB and EC, which induced distinguished features in the gut microbiota and their related functions. This study showed that PB exerts neuroprotective effects in aged mice, the mechanism of which might be different from that of EC. Therefore, PB has a potential as dietary supplement for ameliorating cognitive dysfunction and neuroinflammation in elderly individuals.


Assuntos
Envelhecimento/metabolismo , Disfunção Cognitiva/prevenção & controle , Suplementos Nutricionais , Hipocampo/metabolismo , Fármacos Neuroprotetores/farmacologia , Envelhecimento/patologia , Animais , Galinhas , Disfunção Cognitiva/metabolismo , Disfunção Cognitiva/patologia , Hipocampo/patologia , Inflamação , Masculino , Camundongos , Fármacos Neuroprotetores/química , Especificidade da Espécie
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