Cerebral small vessel disease is a major vascular contributor to cognitive impairment and dementia.However,there remains a lack of effective preventative or therapeutic regimens for cerebral small vessel disease.In th...Cerebral small vessel disease is a major vascular contributor to cognitive impairment and dementia.However,there remains a lack of effective preventative or therapeutic regimens for cerebral small vessel disease.In this study,we investigated the potential therapeutic effects of MCC950,a selective NOD-like receptor family pyrin domain-containing protein 3 inhibitor,on cerebral small vessel disease pathogenesis and cognitive decline in spontaneously hypertensive rats.Our results showed that chronic administration of MCC950(10 mg/kg)to spontaneously hypertensive rats inhibited NOD-like receptor family pyrin domain-containing protein 3 inflammasome activation,thereby considerably suppressing the production of pyroptosis executive protein gasdermin D and pro-inflammatory factors,including interleukin-1βand-18.A decrease in astrocytic and microglial activation was also observed.We also found that MCC950 significantly inhibited autophagy.More importantly,behavioral assessment indicated that MCC950 administration ameliorated impaired neurocognitive function,which was associated with improvements in neuropathological hallmarks in the cerebral small vessel disease brain,such as blood‒brain barrier breakdown,white matter damage,and endothelial dysfunction.Thus,our findings revealed that the NOD-like receptor family pyrin domain-containing protein 3 inflammasome is a key contributor to the onset or progression of cerebral small vessel disease and suggested the potential of NOD-like receptor family pyrin domain-containing protein 3-based therapy as a potential novel strategy for treating cerebral small vessel disease.展开更多
Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has ...Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has been shown to enhance cerebral blood flow in mice,but its efficacy in a model of vascular cognitive impairment and dementia remains unclear.In this study,we established a mouse model of vascular cognitive impairment and dementia by bilateral carotid artery stenosis.Intermittent hypoxia was induced before and after this stenosis.We found that intermittent hypoxia increased cerebral blood flow,oxygen saturation,and microcirculation in the prefrontal cortex and hippocampus in the model mice,without causing neurovascular damage.Additionally,intermittent hypoxia significantly improved cognitive function in the mouse model of vascular cognitive impairment and dementia,with perconditioning showing greater efficacy than preconditioning.Improvements in cerebral microcirculation and blood flow were positively correlated with cognitive recovery.Even in a mouse model of vascular cognitive impairment and dementia with comorbidities induced by a high-fat,high-fructose diet,intermittent hypoxic perconditioning demonstrated protective effects on cognitive function.Proteomic analysis indicated that mitochondrial protection is a key mechanism,particularly through upregulating NDUFB8 expression and increasing the activity of mitochondrial complex I.These findings suggest that intermittent hypoxia is a potential non-invasive strategy for the prevention and treatment of vascular cognitive impairment and dementia.展开更多
Multivitamins were widely used health supplements that replenished essential nutrients in the human body.Despite their popularity,the impact of multivitamins on the cognitive function of older adults remained unclear ...Multivitamins were widely used health supplements that replenished essential nutrients in the human body.Despite their popularity,the impact of multivitamins on the cognitive function of older adults remained unclear and contentious.This study offered a comprehensive review and meta-analysis of research published until June 2024,analyzing the effects of multivitamins on various cognitive functions in individuals aged 65 and older.We included ten randomized controlled trials encompassing 13,600 participants from multiple databases.These studies evaluated the impact of multivitamins on reasoning,memory,learning,visual perception,idea production,cognitive speed,psychomotor abilities,and higher cognitive functions.Our meta-analysis revealed that multivitamins significantly enhanced delayed free recall(SMD=0.09,95%confidence interval(CI)=[0.05,0.13],P=0.0001).However,they had no substantial effects on immediate free recall(SMD=0.85,95%CI=[-0.1,1.9],P=0.11),idea production(SMD=0.00,95%CI=[-0.04,0.03],P=0.86),or cognitive functioning(SMD=0.07,94%CI=[-0.07,0.14],P=0.006).Thus,while multivitamins facilitated delayed free recall,they did not significantly improve other cognitive functions in older adults.展开更多
Background:Health benefits have been reported for many physical activity(PA)interventions for improving fundamental movement skills(FMS)and cognitive function(CF),but the most effective type of PA interventions for em...Background:Health benefits have been reported for many physical activity(PA)interventions for improving fundamental movement skills(FMS)and cognitive function(CF),but the most effective type of PA interventions for emhancing FMS and CF in early childhood remain unknown.Thus,the study aimed to determine the effects of PA interventions in enhancing FMS and CF among young children and to establish the optimal types of PA interventions.Methods:Six electronic databases(PubMed,OVID,SPORTDiscus,Scopus,Web of Science,and Cochrane)were searched for studies from inception to March 17,2024.Randomized controlled trials(RCTs)were included in this study if they reported outcomes related to FMS,CF,or both associated with PA interventions.Effect sizes were calculated and performed as Hedges'g.The hierarchy of competing interventions was established using the surface under the cumulative ranking curve(SUCRA).Risk of bias was independently assessed using the Cochrane Riskof-Bias 2.Results:This analysis included 38 studies with 5237 young children,with sample sizes ranging from 32 to 897 participants.The types of PA interventions analyzed included active play/free play/unstructured PA(AP),general structured PA(GSPA),FMS-targeted PA programs(FMSprograms),cognitively-engaging PA programs(CPA),multilevel PA interventions(MPA),and exergaming.PA interventions had a large,pooled effect size for total FMS(g=0.96;95%CI:0.45-1.46;p<0.01;I^(2)=94%).For CF,a small-to-moderate pooled effect size was found(g=0.39;95%CI:0.18-0.60;p<0.01;I^(2)=88%).PA interventions longer than 3 months showed fewer benefits for FMS(p<0.01).The network meta-analysis showed that FMS-programs(standardized mean difference((SMD)=1.55,95%CI:0.98-2.11,SUCRA=98.3%)and GSPA(SMD=0.94,95%CI:0.05-1.85,SUCRA=69.8%)significantly improved total FMS compared to AP.For locomotor skills(LMS),exergaming ranked highest(SUCRA=79.3%),followed by FMS-programs(75.9%)and GSPA(61.6%).However,despite its top ranking,exergaming's effect estimate was not statistically significant(SMD=1.38,95%CI:-0.08 to 2.85).For object control skills(OCS),exergaming again ranked highest(SUCRA=91.9%)and showed the largest significant effect(SMD=2.38,95%CI:0.96-3.80),followed by FMS-programs(SUCRA=78.5%)and GSPA(SUCRA=53.7%).FMS-programs,GSPA,MPA,and UC also significantly improved OCS compared to AP.While no significant differences were observed across PA interventions for most CF domains,exergaming had a significant positive effect on working memory(SMD=1.41,95%CI:0.07-2.75).The certainty of evidence varied from low to moderate.Conclusion:These findings emphasize the importance of PA interventions in improving FMS and CF in early childhood.FMS-programs and GSPA appear to be the most effective approaches for enhancing total FMS,while exergaming showed the highest ranking for LMS and OCS,with a significant impact on OCS but uncertainty in LMS improvements.Additionally,exergaming had a positive effect on working memory,suggesting its potential cognitive benefits.展开更多
BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.展开更多
This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging i...This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.展开更多
Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ER...Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ERT improves body function,ADL and cognition after stroke.The secondary objectives were to evaluate whether ERT improves strength,gait,quality of life,and self-perceived health.Seven electronic databases were searched:Cochrane Central Register of Controlled Trials,Cochrane Stroke Group Trials Register,PubMed,Epistemonikos,Embase,SPORTDiscus,and WHO International Clinical Trials Registry Platform.Last search was run in December 2023,including studies since 2012.Selection criteria were studies with stroke participants of both sexes,aged 18 or more,with an intervention based on ERT.Accepted languages were English,Spanish or French.First search was done in pairs.Authors removed duplicate studies and those which did not meet inclusion criteria through title and abstracts.Finally,all authors,independently,screened the final search results and extracted data.Of 68 records identified,15 were eligible and 6 were finally included(with moderate risk of bias),analyzing 159 participants.Body function(4 interventions,n=84),gait(4 interventions,n=115)and strength(3 interventions,n?78)showed significantly better results when ERT was performed.Meta-analysis could not be done because of the few studies and their heterogeneity.This review provided low-moderate quality evidence suggesting that ERT might be effective at improving body function,strength,and gait after stroke.Besides,no harm was documented,and it was well-accepted.展开更多
Abnormal bile acid(BA)metabolism has been implicated in the pathogenesis of central nervous system(CNS)diseases,but its role in epilepsy remains unclear.In this study,we investigated the relationship between gut micro...Abnormal bile acid(BA)metabolism has been implicated in the pathogenesis of central nervous system(CNS)diseases,but its role in epilepsy remains unclear.In this study,we investigated the relationship between gut microbiota-driven dysregulation of BA metabolism and seizure-induced ferroptotic neuronal death in epilepsy.Our targeted metabolomic analysis revealed elevated levels of deoxycholic acid(DCA)in the serum and cerebrospinal fluid(CSF)of epileptic patients,which correlated with cognitive impairment.In a pentylenetetrazol(PTZ)-induced mouse model of epilepsy,16S ribosomal RNA(16S rRNA)sequencing showed significant alterations in gut microbiota composition.Importantly,fecal microbiota transplantation(FMT)from healthy mice into epileptic mice significantly reduced seizure activity and improved cognitive function,primarily by normalizing serum and brain levels of secondary bile acids(SBAs),including DCA.Both in vitro and in vivo experiments demonstrated that DCA promotes ferroptosis in hippocampal neurons by activating the farnesoid X receptor(FXR).This activation triggered the nuclear factor erythroid 2-related factor 2(Nrf2)-heme oxygenase-1(HO-1)signaling pathway,known to be involved in oxidative stress and cell death regulation.Our findings suggest that the upregulation of DCA,through its effects on FXR and HO-1,plays a critical role in the progression of epilepsy by inducing ferroptosis in hippocampal neurons.Targeting the DCA-FXR-HO-1 axis may provide a novel therapeutic strategy for treating seizures and associated cognitive deficits in epilepsy.展开更多
BACKGROUND Mild cognitive impairment(MCI)is common in atrial fibrillation(AF)patients and may develop earlier in those with multiple cardiovascular comorbidities,potentially impairing self-management and treatment adh...BACKGROUND Mild cognitive impairment(MCI)is common in atrial fibrillation(AF)patients and may develop earlier in those with multiple cardiovascular comorbidities,potentially impairing self-management and treatment adherence.This study aimed to characterize the prevalence and profile of MCI in AF patients,examine its associations with cardiovascular comorbidities,and assess how these comorbidities influence specific cognitive domains.METHODS This cross-sectional study analyzed data from AF patients who underwent cognitive assessment between 2017 and 2021.Cognitive status was categorized as MCI or non-MCI based on the Montreal Cognitive Assessment.Associations between comorbidities and MCI were assessed by logistic regression,and cognitive domains were compared using the Mann-Whitney U test.RESULTS Of 4136 AF patients(mean age:64.7±9.4 years,64.7%male),33.5%of patients had MCI.Among the AF patients,31.2%of patients had coronary artery disease,20.1%of patients had heart failure,and 18.1%of patients had hypertension.88.7%of patients had left atrial enlargement,and 11.0%of patients had reduced left ventricular ejection fraction.Independent factors associated with higher MCI prevalence included older age(OR=1.04,95%CI:1.03-1.05,P<0.001),lower education level(OR=1.51,95%CI:1.31-1.73,P<0.001),hypertension(OR=1.28,95%CI:1.07-1.52,P=0.001),heart failure(OR=1.24,95%CI:1.04-1.48,P=0.020),and lower left ventricular ejection fraction(OR=1.43,95%CI:1.04-1.98,P=0.028).A higher CHA_(2)DS_(2)-VASc score(OR=1.27,95%CI:1.22-1.33,P<0.001;≥2 points vs.<2 points),and greater atherosclerotic cardiovascular disease burden(OR=1.45,95%CI:1.02-2.08,P=0.040;2 types vs.0 type)were linked to increased MCI risk.These above factors influenced various cognitive domains.CONCLUSIONS MCI is common in AF and closely associated with cardiovascular multimorbidity.Patients with multiple comorbidities are at higher risk,highlighting the importance of routine cognitive assessment to support self-management and integrated care.展开更多
An unauthorised version of the Chinese MMSE was used in this article by the authors without permission from the copyright owner,PAR.Necessary permission has now been retrospectively obtained from PAR.The MMSE is a cop...An unauthorised version of the Chinese MMSE was used in this article by the authors without permission from the copyright owner,PAR.Necessary permission has now been retrospectively obtained from PAR.The MMSE is a copyrighted instrument and may not be used or reproduced in whole or in part,in any form or language,or by any means without the written permission of PAR(www.parinc.com).展开更多
Objectives:This prospective cohort study examined the change trajectories of cognitive and physical functions of individuals with motoric cognitive risk(MCR)syndrome,as well as the longitudinal associations between MC...Objectives:This prospective cohort study examined the change trajectories of cognitive and physical functions of individuals with motoric cognitive risk(MCR)syndrome,as well as the longitudinal associations between MCR syndrome and changes in cognitive and physical functions,to provide a new perspective on preventing dementia.Methods:Participants were selected from the China Health and Retirement Longitudinal Study(CHARLS).Demographic characteristics,health status,and lifestyle variables were assessed in 2011.MCR syndrome was defined as the presence of subjective cognitive complaints and objective slow gait,with preserved activities of daily living and absence of dementia,and assessed in 2011.Cognitive function,including orientation,attention and calculation,episodic memory,and visuospatial ability,was measured from 2011 to 2018.Physical function,including grip strength,balance ability,and repeated chair stand tests,was measured from 2011 to 2015.Generalized estimating equation was employed to analyze the longitudinal associations between MCR syndrome in 2011 and changes in cognitive functions over 7 years and physical functions over 4 years.Results:Among 4,217 participants,475 had MCR syndrome in 2011.Both participants with MCR syndrome and those without exhibited a decline in both cognitive and physical function over 7 years and 4 years of follow-up,except for fluctuations in visuospatial ability.Non-MCR syndrome participants demonstrated significantly better overall cognitive function in 2018 compared to 2011(Group×Time:B=0.44,P=0.035)than those in the MCR syndrome group.However,participants with non-MCR syndrome demonstrated significantly worse visuospatial ability in 2013(Group×time:B=−0.44,P=0.002)and 2018(Group×time:B=−0.34,P=0.016)compared to those in the MCR syndrome group.Non-MCR syndrome participants demonstrated significantly better performance in repeated chair stand tests in 2013(Group×time:B=0.31,P<0.001)and 2015(Group×time:B=0.37,P<0.001)compared to those in the MCR syndrome group in 2011.Conclusions:Older adults with MCR syndrome experience worse overall cognitive and physical function performance,especially in repeated chair stand tests,than individuals without MCR syndrome over 7-year and 4-year follow-up periods.It is suggested that future interventional studies will target both physical and cognitive functions in MCR syndrome individuals,providing insights for the prevention of dementia.展开更多
Intracranial aneurysms,characterized by focal arterial wall dilation,pose significant neurosurgical challenges due to their potential for rupture and hemorrhage,leading to severe clinical outcomes,including fatality.P...Intracranial aneurysms,characterized by focal arterial wall dilation,pose significant neurosurgical challenges due to their potential for rupture and hemorrhage,leading to severe clinical outcomes,including fatality.Patients often experience profound psychological and social impacts,such as depression,anxiety,and cognitive impairment,affecting their quality of life.Rapid progression and high mortality necessitate timely intervention.Advances in neurosurgical techniques,including microscopic surgery and neuroendoscopy,offer distinct advantages.Microscopic surgery provides precision and direct visualization,while neuroendoscopy ensures minimally invasive access and reduced tissue trauma.Integrating these methods optimizes treatment efficacy and clinical outcomes.AIM To evaluate the impact of combined microscopic and neuroendoscopic techniques on psychological,cognitive outcomes,and quality of life in patients with ruptured intracranial aneurysms.METHODS The study focused on 189 patients with intracranial aneurysm rupture and hemorrhage from January 2020 to May 2024 as the objects of observation and analysis.They were randomly divided into a control group(treated with simple microscope surgery,n=94)and an observation group(treated with microscope combined with neuroendoscopy,n=95).The treatment effects of the two groups were observed,mainly including depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data.RESULTS Before treatment,the depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data of the two groups of patients at different time points were compared,and there was no statistically significant difference(P>0.05).After microscope combined with neuroendoscopy treatment,the study revealed that the observation group surpassed the control group in alleviating depression and anxiety,accelerating cognitive function recovery,and enhancing quality of life,with these differences being statistically significant(P<0.05).CONCLUSION Surgical treatment combined with microscopy and neuroendoscopy has a significant positive effect on the mental health,cognitive function and overall quality of life of patients with intracranial aneurysm rupture and bleeding,can shorten the operation time and treatment time,and provides a new strategic reference for clinical treatment.展开更多
In 2019,China had over 13.14 million dementia cases,with incidence rates of(56.47–207.08)/100,000[1].Early cognitive impairment—a key dementia symptom—reduces quality of life,increases care dependence,and lowers su...In 2019,China had over 13.14 million dementia cases,with incidence rates of(56.47–207.08)/100,000[1].Early cognitive impairment—a key dementia symptom—reduces quality of life,increases care dependence,and lowers survival in older adults[2].A decline in physical function can also be observed in older adults with increasing age.Grip strength has been shown to be a marker of overall physiological function in older adults.展开更多
BACKGROUND Many patients with coronavirus disease 2019(COVID-19)may experience emotional issues and cognitive impairment.However,it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of...BACKGROUND Many patients with coronavirus disease 2019(COVID-19)may experience emotional issues and cognitive impairment.However,it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of psychopathological symptoms.It remains unclear whether anxiety and depression are caused by stressors or viral infection.AIM To use functional near-infrared spectroscopy(fNIRS)to detect cortical hemodynamic changes in patients with COVID-19 and their relationship with mental symptoms(mainly depression and anxiety),to investigate whether COVID-19 causes these changes by affecting brain function.METHODS A total of 58 subjects,comprising 29 patients with first acute COVID-19 infection and 29 healthy controls without COVID-19 infection and without anxiety or depression were recruited.Then cortical activation during the performance of the verbal fluency test(VFT)and brain connectivity during the resting state(rs)were evaluated by 53-channel fNIRS.For the COVID-19-infected group,Patient Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7)were used to assess the emotional state before fNIRS measures.RESULTS For the rs,compared to the uninfected group,the infected group exhibited lower rs functional connectivity(FC)in the dorsolateral prefrontal cortex(DLPFC),which was correlated with both the PHQ score and GAD score.During the VFT,the infected group exhibited significantly lower cortical activation than the uninfected group in both Broca-left and Broca-right.Besides,the integral value in the DLPFC-L showed a significant negative correlation with the PHQ-9 score during the VFT in the infected group.CONCLUSION There were significant differences in the bilateral Broca area and DLPFC between the COVID-19-infected and uninfected groups,which may be the reason why COVID-19 infection impairs cognitive function and language function and leads to psychiatric symptoms.In addition,the rsFC in patients with COVID-19 was positively correlated with the severity of depression and anxiety,which may be related to the fact that the mental symptoms of patients with COVID-19 are characterized by depression and anxiety,rather than depression or anxiety alone.Our study provides evidence that the psychological and emotional issues caused by COVID-19 are not only due to external social factors but also involve more direct brain neural mechanisms and abnormal neural circuits,which also provide insights into the future treatment and prognosis of individuals with COVID-19.展开更多
Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as t...Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.展开更多
Background Evidence on the effects of different exercise interventions on cognitive function is insufficient.Aims To evaluate the feasibility and effects of remotely supervised aerobic exercise(AE)and resistance exerc...Background Evidence on the effects of different exercise interventions on cognitive function is insufficient.Aims To evaluate the feasibility and effects of remotely supervised aerobic exercise(AE)and resistance exercise(RE)interventions in older adults with mild cognitive impairment(MCI).Methods This study is a 6-month pilot three-arm randomised controlled trial.Eligible participants(n=108)were recruited and randomised to the AE group,RE group or control(CON)group with a 1:1:1 ratio.Interventions were delivered at home with remote supervision.We evaluated participants’global cognition,memory,executive function,attention,physical activity levels,physical performance and muscle strength of limbs at baseline,3 months(T1)and 6 months(T2)after randomisation.A linear mixed-effects model was adopted for data analyses after controlling for covariates.Tukey’s method was used for adjusting for multiple comparisons.Sensitivity analyses were performed after excluding individuals with low compliance rates.Results 15(13.89%)participants dropped out.The median compliance rates in the AE group and RE group were 67.31%and 93.27%,respectively.After adjusting for covariates,the scores of the Alzheimer’s Disease Assessment Scale-Cognitive subscale in the AE group decreased by 2.04(95%confidence interval(CI)−3.41 to−0.67,t=−2.94,p=0.004)and 1.53(95%CI−2.88 to−0.17,t=−2.22,p=0.028)points more than those in the CON group at T1 and T2,respectively.The effects of AE were still significant at T1(estimate=−1.70,95%CI−3.20 to−0.21,t=−2.69,p=0.021),but lost statistical significance at T2 after adjusting for multiple comparisons.As for executive function,the Stroop time interference in the RE group decreased by 11.76 s(95%CI−21.62 to−1.90,t=−2.81,p=0.015)more than that in the AE group at T2 after Tukey’s adjustment.No other significant effects on cognitive functions were found.Conclusions Both remotely supervised AE and RE programmes are feasible in older adults with MCI.AE has positive effects on global cognition,and RE improves executive function.展开更多
Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design...Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.展开更多
Autophagy directly regulates the amyloid beta-peptide(Aβ)clearance,and its dysfunction occurs in the early pathogenesis of Alzheimer's disease(AD).We previously reported that docosahexaenoic acid-acylated astaxan...Autophagy directly regulates the amyloid beta-peptide(Aβ)clearance,and its dysfunction occurs in the early pathogenesis of Alzheimer's disease(AD).We previously reported that docosahexaenoic acid-acylated astaxanthin monoester(AST-DHA)showed neuroprotection against AD pathology.However,its in-depth mechanism and autophagic responses in AD brains are poorly understood.Herein,SH-SY5Y cells overexpressing the Swedish mutation(K595N/M596L)of APP gene were established to preliminarily evaluate the actions of AST-DHA on reducing Aβ_(1-42)levels and regulating autophagy.In microglial BV2 cells,AST-DHA and free astaxanthin(F-AST)recovered p62 and LC3Ⅱ/Ⅰlevels,and restored autophagy flux by rescuing the late phase of microglial autophagy.Notably,autophagic inhibitor bafilomycin A1 blunted the abilities of AST-DHA to reduce Aβ_(1-42)and fibral Aβ,suggesting that AST-DHA probably promoted Aβclearance in a microglial autophagy-dependent manner.Further studies in APP/PS1 mice verified that dietary AST-DHA and F-AST promoted Aβphagocytosis via microglial autophagy.Significant decreases of Iba1 and p62 were observed around Aβplaque in the hippocampus and cortex using triple fluorescence staining.Furthermore,AST-DHA exhibited superior performance over F-AST in restoring autophagic dysfunction,ameliorating Aβburden and cognitive deficit.Our findings suggest a possible mechanism of AST-DHA in improving AD by which it restores microglial autophagy to facilitate cerebral Aβclearance.It supports the future application of AST-DHA as an autophagic regulator in maintaining brain function.展开更多
The quality of life in older adulthood is greatly influenced by cognitive aging,which in turn is affected by nutrition,especially as it relates to hippocampal function.Although the link between hippocampal function an...The quality of life in older adulthood is greatly influenced by cognitive aging,which in turn is affected by nutrition,especially as it relates to hippocampal function.Although the link between hippocampal function and nutrition is defined,the exact mechanics are still unknown.The commentary addresses how docosahexaenoic acid(DHA)contributes to age-related cognitive decline and may play a role in promoting neurogenesis and neuroplasticity on the molecular level.The current challenge to our understanding is to investigate how DHA influences hippocampal function and cognitive aging,whichwould be possible and evenmore detailedwith the investigation of the mechanisms of signaling pathways.We also discuss what types of future studies are needed to clarify the mechanisms,optimal conditions,and individual factors influencing the hippocampal effects of DHA supplementation.展开更多
BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,eff...BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,effective treatment options,particularly for cognitive dysfunction,remain limited.AIM To evaluate the efficacy of computerized cognitive behavioral therapy(CCBT)with sertraline vs sertraline monotherapy in improving depressive symptoms,cognitive function,and quality of life in schizophrenia and depressive episodes.METHODS In this single-center,randomized controlled trial,68 adults[mean age(SD)=36.5(10.0),57.4%male]with schizophrenia and depressive symptoms were randomly assigned to receive either CCBT with sertraline or sertraline monotherapy during a 4-week hospitalization.The CCBT intervention involved 45-60-minute sessions twice weekly for four weeks.Outcomes included comparisons of depressive symptoms(Calgary depression scale for schizophrenia),cognitive function[MATRICS consensus cognitive battery(MCCB)],and quality of life(36-item short form survey)between the groups.RESULTS The experimental group showed greater improvements in depressive symptoms at 4,8,and 12 weeks compared to the controls,with the most notable difference at 12 weeks[mean difference(MD)=-1.7;P<0.001;Cohen’s d=0.9].Cognitive function improved across all MCCB domains in the experimental group,with higher processing speed scores(MD=4.1;P=0.043;Cohen’s d=0.5)and social cognition scores(MD=4.9;P=0.006;Cohen’s d=0.7)than in the control group.Quality of life,particularly in mental health,was significantly better in the experimental group.CONCLUSION CCBT with sertraline was more effective than sertraline monotherapy for patients with schizophrenia and depressive episodes,supporting its use as an adjunctive therapy.展开更多
基金supported by the National Natural Science Foundation of China,No.82201626(to CC)the Natural Science Foundation of LiaoningProvince,No.2022-MS-442(to CC)the Dalian Municipal Medical Key Specialty Climbing Project,No.2024ZZ040(to MZ).
文摘Cerebral small vessel disease is a major vascular contributor to cognitive impairment and dementia.However,there remains a lack of effective preventative or therapeutic regimens for cerebral small vessel disease.In this study,we investigated the potential therapeutic effects of MCC950,a selective NOD-like receptor family pyrin domain-containing protein 3 inhibitor,on cerebral small vessel disease pathogenesis and cognitive decline in spontaneously hypertensive rats.Our results showed that chronic administration of MCC950(10 mg/kg)to spontaneously hypertensive rats inhibited NOD-like receptor family pyrin domain-containing protein 3 inflammasome activation,thereby considerably suppressing the production of pyroptosis executive protein gasdermin D and pro-inflammatory factors,including interleukin-1βand-18.A decrease in astrocytic and microglial activation was also observed.We also found that MCC950 significantly inhibited autophagy.More importantly,behavioral assessment indicated that MCC950 administration ameliorated impaired neurocognitive function,which was associated with improvements in neuropathological hallmarks in the cerebral small vessel disease brain,such as blood‒brain barrier breakdown,white matter damage,and endothelial dysfunction.Thus,our findings revealed that the NOD-like receptor family pyrin domain-containing protein 3 inflammasome is a key contributor to the onset or progression of cerebral small vessel disease and suggested the potential of NOD-like receptor family pyrin domain-containing protein 3-based therapy as a potential novel strategy for treating cerebral small vessel disease.
基金supported by the Beijing Nova Program,Nos.20230484436,Z211100002121038the Chinese Institutes for Medical Research,No.CX23YQ01+1 种基金the NationalNatural Science Foundation of China,Nos.32100925,82027802Beijing-Tianjin-Hebei Basic Research Cooperation Project,No.22JCZXJC00190(all to XJand JL).
文摘Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has been shown to enhance cerebral blood flow in mice,but its efficacy in a model of vascular cognitive impairment and dementia remains unclear.In this study,we established a mouse model of vascular cognitive impairment and dementia by bilateral carotid artery stenosis.Intermittent hypoxia was induced before and after this stenosis.We found that intermittent hypoxia increased cerebral blood flow,oxygen saturation,and microcirculation in the prefrontal cortex and hippocampus in the model mice,without causing neurovascular damage.Additionally,intermittent hypoxia significantly improved cognitive function in the mouse model of vascular cognitive impairment and dementia,with perconditioning showing greater efficacy than preconditioning.Improvements in cerebral microcirculation and blood flow were positively correlated with cognitive recovery.Even in a mouse model of vascular cognitive impairment and dementia with comorbidities induced by a high-fat,high-fructose diet,intermittent hypoxic perconditioning demonstrated protective effects on cognitive function.Proteomic analysis indicated that mitochondrial protection is a key mechanism,particularly through upregulating NDUFB8 expression and increasing the activity of mitochondrial complex I.These findings suggest that intermittent hypoxia is a potential non-invasive strategy for the prevention and treatment of vascular cognitive impairment and dementia.
基金supported by the Fundamental Research Funds for the Central Universities(2042023gf0003)Hubei Provincial Natural Science Foundation of China(2024AFD126)National Key Research and Development Program of China(2023YFF1104404).
文摘Multivitamins were widely used health supplements that replenished essential nutrients in the human body.Despite their popularity,the impact of multivitamins on the cognitive function of older adults remained unclear and contentious.This study offered a comprehensive review and meta-analysis of research published until June 2024,analyzing the effects of multivitamins on various cognitive functions in individuals aged 65 and older.We included ten randomized controlled trials encompassing 13,600 participants from multiple databases.These studies evaluated the impact of multivitamins on reasoning,memory,learning,visual perception,idea production,cognitive speed,psychomotor abilities,and higher cognitive functions.Our meta-analysis revealed that multivitamins significantly enhanced delayed free recall(SMD=0.09,95%confidence interval(CI)=[0.05,0.13],P=0.0001).However,they had no substantial effects on immediate free recall(SMD=0.85,95%CI=[-0.1,1.9],P=0.11),idea production(SMD=0.00,95%CI=[-0.04,0.03],P=0.86),or cognitive functioning(SMD=0.07,94%CI=[-0.07,0.14],P=0.006).Thus,while multivitamins facilitated delayed free recall,they did not significantly improve other cognitive functions in older adults.
文摘Background:Health benefits have been reported for many physical activity(PA)interventions for improving fundamental movement skills(FMS)and cognitive function(CF),but the most effective type of PA interventions for emhancing FMS and CF in early childhood remain unknown.Thus,the study aimed to determine the effects of PA interventions in enhancing FMS and CF among young children and to establish the optimal types of PA interventions.Methods:Six electronic databases(PubMed,OVID,SPORTDiscus,Scopus,Web of Science,and Cochrane)were searched for studies from inception to March 17,2024.Randomized controlled trials(RCTs)were included in this study if they reported outcomes related to FMS,CF,or both associated with PA interventions.Effect sizes were calculated and performed as Hedges'g.The hierarchy of competing interventions was established using the surface under the cumulative ranking curve(SUCRA).Risk of bias was independently assessed using the Cochrane Riskof-Bias 2.Results:This analysis included 38 studies with 5237 young children,with sample sizes ranging from 32 to 897 participants.The types of PA interventions analyzed included active play/free play/unstructured PA(AP),general structured PA(GSPA),FMS-targeted PA programs(FMSprograms),cognitively-engaging PA programs(CPA),multilevel PA interventions(MPA),and exergaming.PA interventions had a large,pooled effect size for total FMS(g=0.96;95%CI:0.45-1.46;p<0.01;I^(2)=94%).For CF,a small-to-moderate pooled effect size was found(g=0.39;95%CI:0.18-0.60;p<0.01;I^(2)=88%).PA interventions longer than 3 months showed fewer benefits for FMS(p<0.01).The network meta-analysis showed that FMS-programs(standardized mean difference((SMD)=1.55,95%CI:0.98-2.11,SUCRA=98.3%)and GSPA(SMD=0.94,95%CI:0.05-1.85,SUCRA=69.8%)significantly improved total FMS compared to AP.For locomotor skills(LMS),exergaming ranked highest(SUCRA=79.3%),followed by FMS-programs(75.9%)and GSPA(61.6%).However,despite its top ranking,exergaming's effect estimate was not statistically significant(SMD=1.38,95%CI:-0.08 to 2.85).For object control skills(OCS),exergaming again ranked highest(SUCRA=91.9%)and showed the largest significant effect(SMD=2.38,95%CI:0.96-3.80),followed by FMS-programs(SUCRA=78.5%)and GSPA(SUCRA=53.7%).FMS-programs,GSPA,MPA,and UC also significantly improved OCS compared to AP.While no significant differences were observed across PA interventions for most CF domains,exergaming had a significant positive effect on working memory(SMD=1.41,95%CI:0.07-2.75).The certainty of evidence varied from low to moderate.Conclusion:These findings emphasize the importance of PA interventions in improving FMS and CF in early childhood.FMS-programs and GSPA appear to be the most effective approaches for enhancing total FMS,while exergaming showed the highest ranking for LMS and OCS,with a significant impact on OCS but uncertainty in LMS improvements.Additionally,exergaming had a positive effect on working memory,suggesting its potential cognitive benefits.
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
文摘This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.
文摘Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ERT improves body function,ADL and cognition after stroke.The secondary objectives were to evaluate whether ERT improves strength,gait,quality of life,and self-perceived health.Seven electronic databases were searched:Cochrane Central Register of Controlled Trials,Cochrane Stroke Group Trials Register,PubMed,Epistemonikos,Embase,SPORTDiscus,and WHO International Clinical Trials Registry Platform.Last search was run in December 2023,including studies since 2012.Selection criteria were studies with stroke participants of both sexes,aged 18 or more,with an intervention based on ERT.Accepted languages were English,Spanish or French.First search was done in pairs.Authors removed duplicate studies and those which did not meet inclusion criteria through title and abstracts.Finally,all authors,independently,screened the final search results and extracted data.Of 68 records identified,15 were eligible and 6 were finally included(with moderate risk of bias),analyzing 159 participants.Body function(4 interventions,n=84),gait(4 interventions,n=115)and strength(3 interventions,n?78)showed significantly better results when ERT was performed.Meta-analysis could not be done because of the few studies and their heterogeneity.This review provided low-moderate quality evidence suggesting that ERT might be effective at improving body function,strength,and gait after stroke.Besides,no harm was documented,and it was well-accepted.
基金supported by the National Natural Science Foundation of China(Grant No.:82201808)the Natural Science Foundation of Jiangsu Province(Grant No.:BK20221221).
文摘Abnormal bile acid(BA)metabolism has been implicated in the pathogenesis of central nervous system(CNS)diseases,but its role in epilepsy remains unclear.In this study,we investigated the relationship between gut microbiota-driven dysregulation of BA metabolism and seizure-induced ferroptotic neuronal death in epilepsy.Our targeted metabolomic analysis revealed elevated levels of deoxycholic acid(DCA)in the serum and cerebrospinal fluid(CSF)of epileptic patients,which correlated with cognitive impairment.In a pentylenetetrazol(PTZ)-induced mouse model of epilepsy,16S ribosomal RNA(16S rRNA)sequencing showed significant alterations in gut microbiota composition.Importantly,fecal microbiota transplantation(FMT)from healthy mice into epileptic mice significantly reduced seizure activity and improved cognitive function,primarily by normalizing serum and brain levels of secondary bile acids(SBAs),including DCA.Both in vitro and in vivo experiments demonstrated that DCA promotes ferroptosis in hippocampal neurons by activating the farnesoid X receptor(FXR).This activation triggered the nuclear factor erythroid 2-related factor 2(Nrf2)-heme oxygenase-1(HO-1)signaling pathway,known to be involved in oxidative stress and cell death regulation.Our findings suggest that the upregulation of DCA,through its effects on FXR and HO-1,plays a critical role in the progression of epilepsy by inducing ferroptosis in hippocampal neurons.Targeting the DCA-FXR-HO-1 axis may provide a novel therapeutic strategy for treating seizures and associated cognitive deficits in epilepsy.
基金supported by the National Natural Science Foundation of China(No.82270316)the Beijing Municipal Commission of Science and Technology(Z24-1100007724008).
文摘BACKGROUND Mild cognitive impairment(MCI)is common in atrial fibrillation(AF)patients and may develop earlier in those with multiple cardiovascular comorbidities,potentially impairing self-management and treatment adherence.This study aimed to characterize the prevalence and profile of MCI in AF patients,examine its associations with cardiovascular comorbidities,and assess how these comorbidities influence specific cognitive domains.METHODS This cross-sectional study analyzed data from AF patients who underwent cognitive assessment between 2017 and 2021.Cognitive status was categorized as MCI or non-MCI based on the Montreal Cognitive Assessment.Associations between comorbidities and MCI were assessed by logistic regression,and cognitive domains were compared using the Mann-Whitney U test.RESULTS Of 4136 AF patients(mean age:64.7±9.4 years,64.7%male),33.5%of patients had MCI.Among the AF patients,31.2%of patients had coronary artery disease,20.1%of patients had heart failure,and 18.1%of patients had hypertension.88.7%of patients had left atrial enlargement,and 11.0%of patients had reduced left ventricular ejection fraction.Independent factors associated with higher MCI prevalence included older age(OR=1.04,95%CI:1.03-1.05,P<0.001),lower education level(OR=1.51,95%CI:1.31-1.73,P<0.001),hypertension(OR=1.28,95%CI:1.07-1.52,P=0.001),heart failure(OR=1.24,95%CI:1.04-1.48,P=0.020),and lower left ventricular ejection fraction(OR=1.43,95%CI:1.04-1.98,P=0.028).A higher CHA_(2)DS_(2)-VASc score(OR=1.27,95%CI:1.22-1.33,P<0.001;≥2 points vs.<2 points),and greater atherosclerotic cardiovascular disease burden(OR=1.45,95%CI:1.02-2.08,P=0.040;2 types vs.0 type)were linked to increased MCI risk.These above factors influenced various cognitive domains.CONCLUSIONS MCI is common in AF and closely associated with cardiovascular multimorbidity.Patients with multiple comorbidities are at higher risk,highlighting the importance of routine cognitive assessment to support self-management and integrated care.
文摘An unauthorised version of the Chinese MMSE was used in this article by the authors without permission from the copyright owner,PAR.Necessary permission has now been retrospectively obtained from PAR.The MMSE is a copyrighted instrument and may not be used or reproduced in whole or in part,in any form or language,or by any means without the written permission of PAR(www.parinc.com).
基金supported by the National Natural Science Foundation of China(grant number:72304153)the Supporting Project of National Natural Science Foundation of China from Nanjing University of Chinese Medicine,China,(grant number:XPT72304153)the University Philosophy and Social Science Research in Jiangsu Province Jiangsu Province,China(grant number:2023SJYB0318)。
文摘Objectives:This prospective cohort study examined the change trajectories of cognitive and physical functions of individuals with motoric cognitive risk(MCR)syndrome,as well as the longitudinal associations between MCR syndrome and changes in cognitive and physical functions,to provide a new perspective on preventing dementia.Methods:Participants were selected from the China Health and Retirement Longitudinal Study(CHARLS).Demographic characteristics,health status,and lifestyle variables were assessed in 2011.MCR syndrome was defined as the presence of subjective cognitive complaints and objective slow gait,with preserved activities of daily living and absence of dementia,and assessed in 2011.Cognitive function,including orientation,attention and calculation,episodic memory,and visuospatial ability,was measured from 2011 to 2018.Physical function,including grip strength,balance ability,and repeated chair stand tests,was measured from 2011 to 2015.Generalized estimating equation was employed to analyze the longitudinal associations between MCR syndrome in 2011 and changes in cognitive functions over 7 years and physical functions over 4 years.Results:Among 4,217 participants,475 had MCR syndrome in 2011.Both participants with MCR syndrome and those without exhibited a decline in both cognitive and physical function over 7 years and 4 years of follow-up,except for fluctuations in visuospatial ability.Non-MCR syndrome participants demonstrated significantly better overall cognitive function in 2018 compared to 2011(Group×Time:B=0.44,P=0.035)than those in the MCR syndrome group.However,participants with non-MCR syndrome demonstrated significantly worse visuospatial ability in 2013(Group×time:B=−0.44,P=0.002)and 2018(Group×time:B=−0.34,P=0.016)compared to those in the MCR syndrome group.Non-MCR syndrome participants demonstrated significantly better performance in repeated chair stand tests in 2013(Group×time:B=0.31,P<0.001)and 2015(Group×time:B=0.37,P<0.001)compared to those in the MCR syndrome group in 2011.Conclusions:Older adults with MCR syndrome experience worse overall cognitive and physical function performance,especially in repeated chair stand tests,than individuals without MCR syndrome over 7-year and 4-year follow-up periods.It is suggested that future interventional studies will target both physical and cognitive functions in MCR syndrome individuals,providing insights for the prevention of dementia.
文摘Intracranial aneurysms,characterized by focal arterial wall dilation,pose significant neurosurgical challenges due to their potential for rupture and hemorrhage,leading to severe clinical outcomes,including fatality.Patients often experience profound psychological and social impacts,such as depression,anxiety,and cognitive impairment,affecting their quality of life.Rapid progression and high mortality necessitate timely intervention.Advances in neurosurgical techniques,including microscopic surgery and neuroendoscopy,offer distinct advantages.Microscopic surgery provides precision and direct visualization,while neuroendoscopy ensures minimally invasive access and reduced tissue trauma.Integrating these methods optimizes treatment efficacy and clinical outcomes.AIM To evaluate the impact of combined microscopic and neuroendoscopic techniques on psychological,cognitive outcomes,and quality of life in patients with ruptured intracranial aneurysms.METHODS The study focused on 189 patients with intracranial aneurysm rupture and hemorrhage from January 2020 to May 2024 as the objects of observation and analysis.They were randomly divided into a control group(treated with simple microscope surgery,n=94)and an observation group(treated with microscope combined with neuroendoscopy,n=95).The treatment effects of the two groups were observed,mainly including depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data.RESULTS Before treatment,the depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data of the two groups of patients at different time points were compared,and there was no statistically significant difference(P>0.05).After microscope combined with neuroendoscopy treatment,the study revealed that the observation group surpassed the control group in alleviating depression and anxiety,accelerating cognitive function recovery,and enhancing quality of life,with these differences being statistically significant(P<0.05).CONCLUSION Surgical treatment combined with microscopy and neuroendoscopy has a significant positive effect on the mental health,cognitive function and overall quality of life of patients with intracranial aneurysm rupture and bleeding,can shorten the operation time and treatment time,and provides a new strategic reference for clinical treatment.
基金supported by the Shanghai New Three-year Action Plan for Public Health(Grant No.GWV-10.1-XK16)the US National Institute on Aging(RO1-AGO34479).
文摘In 2019,China had over 13.14 million dementia cases,with incidence rates of(56.47–207.08)/100,000[1].Early cognitive impairment—a key dementia symptom—reduces quality of life,increases care dependence,and lowers survival in older adults[2].A decline in physical function can also be observed in older adults with increasing age.Grip strength has been shown to be a marker of overall physiological function in older adults.
基金Supported by Hunan Provincial Scientific Research Plan Project of Traditional Chinese MedicineNational Natural Science Foundation of China,No.82371521Special Tasks for the Construction of Hunan Innovative Province,No.2023SK4002.
文摘BACKGROUND Many patients with coronavirus disease 2019(COVID-19)may experience emotional issues and cognitive impairment.However,it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of psychopathological symptoms.It remains unclear whether anxiety and depression are caused by stressors or viral infection.AIM To use functional near-infrared spectroscopy(fNIRS)to detect cortical hemodynamic changes in patients with COVID-19 and their relationship with mental symptoms(mainly depression and anxiety),to investigate whether COVID-19 causes these changes by affecting brain function.METHODS A total of 58 subjects,comprising 29 patients with first acute COVID-19 infection and 29 healthy controls without COVID-19 infection and without anxiety or depression were recruited.Then cortical activation during the performance of the verbal fluency test(VFT)and brain connectivity during the resting state(rs)were evaluated by 53-channel fNIRS.For the COVID-19-infected group,Patient Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7)were used to assess the emotional state before fNIRS measures.RESULTS For the rs,compared to the uninfected group,the infected group exhibited lower rs functional connectivity(FC)in the dorsolateral prefrontal cortex(DLPFC),which was correlated with both the PHQ score and GAD score.During the VFT,the infected group exhibited significantly lower cortical activation than the uninfected group in both Broca-left and Broca-right.Besides,the integral value in the DLPFC-L showed a significant negative correlation with the PHQ-9 score during the VFT in the infected group.CONCLUSION There were significant differences in the bilateral Broca area and DLPFC between the COVID-19-infected and uninfected groups,which may be the reason why COVID-19 infection impairs cognitive function and language function and leads to psychiatric symptoms.In addition,the rsFC in patients with COVID-19 was positively correlated with the severity of depression and anxiety,which may be related to the fact that the mental symptoms of patients with COVID-19 are characterized by depression and anxiety,rather than depression or anxiety alone.Our study provides evidence that the psychological and emotional issues caused by COVID-19 are not only due to external social factors but also involve more direct brain neural mechanisms and abnormal neural circuits,which also provide insights into the future treatment and prognosis of individuals with COVID-19.
基金supported by the National Natural Science Foundation of China(82172018 and 62333002).
文摘Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.
基金funded by the National Natural Science Foundation of China(81871854,72374014)the National Key R&D Program of China(2020YFC2008804)+1 种基金the Shanghai Jiao Tong University Young Talent Cultivation Program in Liberal Arts(2024QN041)the Shanghai Jiao Tong University School of Medicine:Nursing Development Program(SJTUHLXK2024).
文摘Background Evidence on the effects of different exercise interventions on cognitive function is insufficient.Aims To evaluate the feasibility and effects of remotely supervised aerobic exercise(AE)and resistance exercise(RE)interventions in older adults with mild cognitive impairment(MCI).Methods This study is a 6-month pilot three-arm randomised controlled trial.Eligible participants(n=108)were recruited and randomised to the AE group,RE group or control(CON)group with a 1:1:1 ratio.Interventions were delivered at home with remote supervision.We evaluated participants’global cognition,memory,executive function,attention,physical activity levels,physical performance and muscle strength of limbs at baseline,3 months(T1)and 6 months(T2)after randomisation.A linear mixed-effects model was adopted for data analyses after controlling for covariates.Tukey’s method was used for adjusting for multiple comparisons.Sensitivity analyses were performed after excluding individuals with low compliance rates.Results 15(13.89%)participants dropped out.The median compliance rates in the AE group and RE group were 67.31%and 93.27%,respectively.After adjusting for covariates,the scores of the Alzheimer’s Disease Assessment Scale-Cognitive subscale in the AE group decreased by 2.04(95%confidence interval(CI)−3.41 to−0.67,t=−2.94,p=0.004)and 1.53(95%CI−2.88 to−0.17,t=−2.22,p=0.028)points more than those in the CON group at T1 and T2,respectively.The effects of AE were still significant at T1(estimate=−1.70,95%CI−3.20 to−0.21,t=−2.69,p=0.021),but lost statistical significance at T2 after adjusting for multiple comparisons.As for executive function,the Stroop time interference in the RE group decreased by 11.76 s(95%CI−21.62 to−1.90,t=−2.81,p=0.015)more than that in the AE group at T2 after Tukey’s adjustment.No other significant effects on cognitive functions were found.Conclusions Both remotely supervised AE and RE programmes are feasible in older adults with MCI.AE has positive effects on global cognition,and RE improves executive function.
基金funded by National Natural Science Foundation of China (grant numbers 82270258,82100260)National Key Research&Development Prog ram of China (grant number 2020YFC2004800)。
文摘Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.
基金supported by the National Natural Science Foundation of China(32302063)Shandong Provincial Natural Science Foundation(ZR2023QC130)。
文摘Autophagy directly regulates the amyloid beta-peptide(Aβ)clearance,and its dysfunction occurs in the early pathogenesis of Alzheimer's disease(AD).We previously reported that docosahexaenoic acid-acylated astaxanthin monoester(AST-DHA)showed neuroprotection against AD pathology.However,its in-depth mechanism and autophagic responses in AD brains are poorly understood.Herein,SH-SY5Y cells overexpressing the Swedish mutation(K595N/M596L)of APP gene were established to preliminarily evaluate the actions of AST-DHA on reducing Aβ_(1-42)levels and regulating autophagy.In microglial BV2 cells,AST-DHA and free astaxanthin(F-AST)recovered p62 and LC3Ⅱ/Ⅰlevels,and restored autophagy flux by rescuing the late phase of microglial autophagy.Notably,autophagic inhibitor bafilomycin A1 blunted the abilities of AST-DHA to reduce Aβ_(1-42)and fibral Aβ,suggesting that AST-DHA probably promoted Aβclearance in a microglial autophagy-dependent manner.Further studies in APP/PS1 mice verified that dietary AST-DHA and F-AST promoted Aβphagocytosis via microglial autophagy.Significant decreases of Iba1 and p62 were observed around Aβplaque in the hippocampus and cortex using triple fluorescence staining.Furthermore,AST-DHA exhibited superior performance over F-AST in restoring autophagic dysfunction,ameliorating Aβburden and cognitive deficit.Our findings suggest a possible mechanism of AST-DHA in improving AD by which it restores microglial autophagy to facilitate cerebral Aβclearance.It supports the future application of AST-DHA as an autophagic regulator in maintaining brain function.
文摘The quality of life in older adulthood is greatly influenced by cognitive aging,which in turn is affected by nutrition,especially as it relates to hippocampal function.Although the link between hippocampal function and nutrition is defined,the exact mechanics are still unknown.The commentary addresses how docosahexaenoic acid(DHA)contributes to age-related cognitive decline and may play a role in promoting neurogenesis and neuroplasticity on the molecular level.The current challenge to our understanding is to investigate how DHA influences hippocampal function and cognitive aging,whichwould be possible and evenmore detailedwith the investigation of the mechanisms of signaling pathways.We also discuss what types of future studies are needed to clarify the mechanisms,optimal conditions,and individual factors influencing the hippocampal effects of DHA supplementation.
基金Supported by Fuzhou Science and Technology Plan Project,No.2023-S-028.
文摘BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,effective treatment options,particularly for cognitive dysfunction,remain limited.AIM To evaluate the efficacy of computerized cognitive behavioral therapy(CCBT)with sertraline vs sertraline monotherapy in improving depressive symptoms,cognitive function,and quality of life in schizophrenia and depressive episodes.METHODS In this single-center,randomized controlled trial,68 adults[mean age(SD)=36.5(10.0),57.4%male]with schizophrenia and depressive symptoms were randomly assigned to receive either CCBT with sertraline or sertraline monotherapy during a 4-week hospitalization.The CCBT intervention involved 45-60-minute sessions twice weekly for four weeks.Outcomes included comparisons of depressive symptoms(Calgary depression scale for schizophrenia),cognitive function[MATRICS consensus cognitive battery(MCCB)],and quality of life(36-item short form survey)between the groups.RESULTS The experimental group showed greater improvements in depressive symptoms at 4,8,and 12 weeks compared to the controls,with the most notable difference at 12 weeks[mean difference(MD)=-1.7;P<0.001;Cohen’s d=0.9].Cognitive function improved across all MCCB domains in the experimental group,with higher processing speed scores(MD=4.1;P=0.043;Cohen’s d=0.5)and social cognition scores(MD=4.9;P=0.006;Cohen’s d=0.7)than in the control group.Quality of life,particularly in mental health,was significantly better in the experimental group.CONCLUSION CCBT with sertraline was more effective than sertraline monotherapy for patients with schizophrenia and depressive episodes,supporting its use as an adjunctive therapy.
