Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia r...Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2500 g),normal birth weight(2500-3999 g),and macrosomia(≥4000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.展开更多
Objective:To translate and adapt the dementia knowledge assessment scale(DKAS)into Sinhala version and to evaluate its psychometric properties among nursing students.Methods:A cross-sectional validation study was cond...Objective:To translate and adapt the dementia knowledge assessment scale(DKAS)into Sinhala version and to evaluate its psychometric properties among nursing students.Methods:A cross-sectional validation study was conducted in two phases:(i)translation and adaptation and(ii)evaluating psychometric properties(N=394 nursing students).Results:The DKAS was adapted to the Sinhala(Si-DKAS)version,and the content validity index(CVI=0.9)was satisfactory.Exploratory factor analysis(EFA)and confirmatory factor analysis(CFA)resulted in an 18-item Si-DKAS with a four-factor model:“care considerations,”“causes and characteristics of dementia,”“health promotion,”and“misconceptions about dementia.”The model fit indices were suboptimal(comparative fix index[CFI]=0.809 and Turker-Lewis index[TLI]=0.773),and some indices were acceptable(standardized root-mean-squared residual[SRMR]=0.040 and root-mean-squared error of approximation[RMSEA]=0.053).Internal consistency(0.7)and test-retest correlation(0.9)were acceptable.Discriminant validity was confirmed by knowledge score differences based on academic years.Conclusions:This is a valid and reliable tool for assessing knowledge of dementia among Sinhala-speaking nursing students.展开更多
Rarer dementias are associated with atypical symptoms and younger onset,which result in a higher burden of care.We provide a review of the global literature on longitudinal decline in activities of daily living(ADLs)i...Rarer dementias are associated with atypical symptoms and younger onset,which result in a higher burden of care.We provide a review of the global literature on longitudinal decline in activities of daily living(ADLs)in dementias that account for less than 10%of dementia diagnoses.Published studies were identified through searches conducted in Medical Literature Analysis and Retrieval System Online(MEDLINE),Excerpta Medica Database(Embase),Excerpta Medica Care(Emcare),PsycINFO,and Cumulative Index in Nursing and Allied Health Literature(CINAHL).The search criteria included terms related to‘rarer dementias’,‘activities of daily living’and‘longitudinal or cross-sectional studies’following a predefined protocol registered.Studies were screened,and those that met the criteria were citation searched.Quality assessments were performed,and relevant data were extracted.20 articles were selected,of which 19 focused on dementias within the frontotemporal dementia/primary progressive aphasia spectrum,while one addressed posterior cortical atrophy.Four studies were cross-sectional and 16 studies were longitudinal,with a median duration of 2.2 years.The Disability Assessment for Dementia was used to measure decline in 8 of the 20 studies.The varied sequences of ADL decline reported in the literature reflect variation in diagnostic specificity between studies and within-syndrome heterogeneity.Most studies used Alzheimer’s disease staging scales to measure decline,which cannot capture variant-specific symptoms.To enhance care provision in dementia,ADL scales could be deployed postdiagnosis to aid treatment and planning.This necessitates staging scales that are variant-specific and span the disease course from diagnosis to end of life.展开更多
With an increase in global aging,the number of people affected by cerebrovascular diseases is also increasing,and the incidence of vascular dementia-closely related to cerebrovascular risk-is increasing at an epidemic...With an increase in global aging,the number of people affected by cerebrovascular diseases is also increasing,and the incidence of vascular dementia-closely related to cerebrovascular risk-is increasing at an epidemic rate.However,few therapeutic options exist that can markedly improve the cognitive impairment and prognosis of vascular dementia patients.Similarly in Alzheimer’s disease and other neurological disorders,synaptic dysfunction is recognized as the main reason for cognitive decline.Nitric oxide is one of the ubiquitous gaseous cellular messengers involved in multiple physiological and pathological processes of the central nervous system.Recently,nitric oxide has been implicated in regulating synaptic plasticity and plays an important role in the pathogenesis of vascular dementia.This review introduces in detail the emerging role of nitric oxide in physiological and pathological states of vascular dementia and summarizes the diverse effects of nitric oxide on different aspects of synaptic dysfunction,neuroinflammation,oxidative stress,and blood-brain barrier dysfunction that underlie the progress of vascular dementia.Additionally,we propose that targeting the nitric oxide-sGC-cGMP pathway using certain specific approaches may provide a novel therapeutic strategy for vascular dementia.展开更多
Dementia is a group of diseases,including Alzheimer's disease(AD),vascular dementia,Lewy body dementia,frontotemporal dementia,Parkinson's disease dementia,metabolic dementia and toxic dementia.The treatment o...Dementia is a group of diseases,including Alzheimer's disease(AD),vascular dementia,Lewy body dementia,frontotemporal dementia,Parkinson's disease dementia,metabolic dementia and toxic dementia.The treatment of dementia mainly includes symptomatic treatment by controlling the primary disease and accompanying symptoms,nutritional support therapy for repairing nerve cells,psychological auxiliary treatment,and treatment that improves cognitive function through drugs.Among them,drug therapy to improve cognitive function is important.This review focuses on introducing and commenting on some recent progress in exploring drugs to improve cognitive function,especially the new progress in drug treatment for AD.We mainly discuss the opportunities and challenges in finding and developing new therapeutic drugs from the aspects of acetylcholinesterase,N-methyl-D-aspartate glutamate receptor,amyloid protein,tau protein and chronic immune inflammation.展开更多
China is facing a rapidly aging population,significantly impacting public health and healthcare systems.According to the"National Report on the Development of Undertakings for the Aged(2022),"there are 280 m...China is facing a rapidly aging population,significantly impacting public health and healthcare systems.According to the"National Report on the Development of Undertakings for the Aged(2022),"there are 280 million people aged 60 years and above in China,accounting for 19.8%of the total population(Fig.1A)[1].This percentage has steadily increased from 14.3%in 2012.Projections indicate that by 2050,the elderly population in China will peak at approximately 487 million,representing 34.9%of the total population[2].In this perspective article,we analyze the current challenges facing China's dementia prevention and control system,with the aim of presenting policy recommendations to effectively address these issues.展开更多
Dementias such as Alzheimer disease(AD)and mild cognitive impairment(MCI)lead to problems with memory,language,and daily activities resulting from damage to neurons in the brain.Given the irreversibility of this neuro...Dementias such as Alzheimer disease(AD)and mild cognitive impairment(MCI)lead to problems with memory,language,and daily activities resulting from damage to neurons in the brain.Given the irreversibility of this neuronal damage,it is crucial to find a biomarker to distinguish individuals with these diseases from healthy people.In this study,we construct a brain function network based on electroencephalography data to study changes in AD and MCI patients.Using a graph-theoretical approach,we examine connectivity features and explore their contributions to dementia recognition at edge,node,and network levels.We find that connectivity is reduced in AD and MCI patients compared with healthy controls.We also find that the edge-level features give the best performance when machine learning models are used to recognize dementia.The results of feature selection identify the top 50 ranked edge-level features constituting an optimal subset,which is mainly connected with the frontal nodes.A threshold analysis reveals that the performance of edge-level features is more sensitive to the threshold for the connection strength than that of node-and network-level features.In addition,edge-level features with a threshold of 0 provide the most effective dementia recognition.The K-nearest neighbors(KNN)machine learning model achieves the highest accuracy of 0.978 with the optimal subset when the threshold is 0.Visualization of edge-level features suggests that there are more long connections linking the frontal region with the occipital and parietal regions in AD and MCI patients compared with healthy controls.Our codes are publicly available at https://github.com/Debbie-85/eeg-connectivity.展开更多
Objective:This study aimed to observe the effects of xiusanzhen acupuncture(olfactory three-needling therapy)on the behavior,hippocampal histopathology and microglial(MG)activation of rats with vascular dementia(VD),a...Objective:This study aimed to observe the effects of xiusanzhen acupuncture(olfactory three-needling therapy)on the behavior,hippocampal histopathology and microglial(MG)activation of rats with vascular dementia(VD),and to assess the role of the trigeminal nerve.Methods:Sprague-Dawley(SD)rats were randomly assigned to the sham-operation,model,xiusanzhen,and trigeminal neurotomy groups(n=15 per group).Bilateral common carotid artery ligation was performed to prepare the VD models.Models of trigeminal neurotomy were prepared through the excision of the frontal nerve and infraorbital nerve.Xiusanzhen acupuncture was delivered via electric stimulation.The acupoints selected were bilateral“Yingxiang(LI20)”and“Yintang(EX-HN3)”,and the stimulation parameters were as follows:disperse-dense wave,at a frequency of 2/15HZ and intensity of 1 mA.The course of treatment was once daily,with one course lasting five days,followed by an interval of two days,yielding a total of four courses.Behavioral changes were detected using the Morris water maze,changes in histomorphology in the hippocampal CA1 region were determined with hematoxylin and eosin(HE)staining,and MG activation in the hippocampal CA1 region was detected using immunofluorescence.Results:The escape latency:From days 3 to 5,the escape latency was higher in the model group compared to the sham-operation group(P<0.05),but was lower in the xiusanzhen group compared to the model and trigeminal neurotomy groups(P<0.05).The frequency for platform crossing and swimming distance:both were reduced in the model group compared to the sham-operation group(P<0.01);and were elevated in the xiusanzhen group compared to the model group and trigeminal neurotomy group(P<0.01).Hippocampal pathomorphological changes:In the sham-operation group,the morphological structure and nucleoli were well-defined;in the model group and the trigeminal neurotomy group,cell numbers were reduced and karyopyknosis increased;while in the xiusanzhen group,the cell numbers were elevated and karyopyknosis was reduced compared with the model group.MG:the positive rate was higher in the model group compared to the sham-operation group(P<0.05);lower in the xiusanzhen group compared to the model group(P<0.05);and higher in the trigeminal neurotomy group compared to the xiusanzhen group(P<0.05).Conclusion:Xiusanzhen acupuncture attenuates cognitive impairment in VD rats,inhibits MG activation,and reduces hippocampal tissue damage.Its effects depend on the structural integrity of the trigeminal nerve.展开更多
Objective:To clarify the concept of in-home respite care in dementia care and identify changes in the service content over time to help providers and users better understand this sustainable service.Method:A literatur...Objective:To clarify the concept of in-home respite care in dementia care and identify changes in the service content over time to help providers and users better understand this sustainable service.Method:A literature search was conducted through Chinese databases China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and SinoMed,as well as English databases PubMed,the Cochrane Library,Web of Sciences,and Embase.Articles published from January 1980 to December 2024 were identified.Rogers’conceptual analysis of evolution was used for this concept analysis,including six steps:identifying the concept and its context,selecting appropriate databases,determining relevant literature,identifying the concept’s attributes,antecedents,and consequences,choosing a concept exemplar if appropriate,and defininghypotheses and implications for further concept development.Results:Thirty-one articles were included.This conceptual analysis revealed the evolution of in-home respite care service content over time and summarized three key attributes.The antecedents included factors related to people with dementia,family caregivers,and the social environment(aging society,government support).The consequences of in-home respite services include delayed institutional placement and reduced security risk events for people with dementia.For family caregivers,consequences include reduced caregiving stress,improved quality of life,and perceived benefitsfrom rest periods.Conclusion:In-home respite care can be interpreted as family-centered home care that provides temporary relief from family caregivers’responsibilities in caring for people with dementia to reduce caregiver burden.The trend of service specialization and attention on dementia families’needs in service provision are future research focus.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
Objective To investigate the effects of WenFei JiangZhuo Formula on cognitive function,serum neurofactors,and cerebral blood flow status in patients with mild-to-moderate vascular dementia(VaD),providing evidence for ...Objective To investigate the effects of WenFei JiangZhuo Formula on cognitive function,serum neurofactors,and cerebral blood flow status in patients with mild-to-moderate vascular dementia(VaD),providing evidence for clinical treatment.Methods A total of 80 patients with mild-to-moderate VaD admitted to our hospital from January 2022 to December 2023 were randomly divided into a control group(40 cases)and an observation group(40 cases)using a random number table.The control group received oral administration of butylphenidyl soft capsules,while the observation group received WenFei JiangZhuo Formula decoction as adjunct therapy.Both groups underwent continuous treatment for 12 weeks.Clinical outcomes were compared including cognitive function scores(MMSE,MoCA),serum neurofactors[brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],and cerebral hemodynamics parameters[peak systolic velocity(Vs),end-diastolic velocity(Vd),mean velocity(Vm)of the middle cerebral artery(MCA)and anterior cerebral artery(ACA)].Clinical efficacy and adverse reactions were statistically analyzed.Results:After treatment,both groups showed significantly improved MMSE and MoCA scores compared to baseline levels(P<0.05),with the observation group demonstrating greater improvement than the control group(P<0.05).Serum BDNF and NGF levels increased significantly in both groups(P<0.05),while TNF-αand IL-6 levels decreased markedly(P<0.05),with the observation group showing better improvement than the control group(P<0.05).Both groups showed significant increases in MCA,ACA,Vs,Vd,and Vm compared to baseline levels(P<0.05),with the observation group outperforming the control group(P<0.05).The overall effective rate in the observation group was 87.50%,significantly higher than the control group's 67.50%(P<0.05).No statistically significant differences were observed in adverse reaction rates between the groups(P>0.05).Conclusion:WenFei JiangZhuo Formula can effectively improve cognitive function in patients with mild-to-moderate VaD.This mechanism may involve upregulating neurotrophic factors,suppressing inflammatory responses,and enhancing cerebral blood flow perfusion,with demonstrated safety profile.展开更多
Chronic cerebral hypoperfusion can lead to neuronal necrosis,trigger inflammatory responses,promote white matter damage,and ultimately result in cognitive impairment.Consequently,chronic cerebral hypoperfusion is an i...Chronic cerebral hypoperfusion can lead to neuronal necrosis,trigger inflammatory responses,promote white matter damage,and ultimately result in cognitive impairment.Consequently,chronic cerebral hypoperfusion is an important factor influencing the onset and progression of vascular dementia.The myelin sheath is a critical component of white matter,and damage and repair of the white matter are closely linked to myelin sheath integrity.This article reviews the role of microglia in vascular dementia,focusing on their effects on myelin sheaths and the potential therapeutic implications.The findings suggest that ischemia and hypoxia cause disruption of the blood-brain barrier and activate microglia,which may worsen blood-brain barrier damage through the release of matrix-degrading enzymes.Microglia-mediated metabolic reprogramming is recognized as an important driver of inflammation.Damage to the blood-brain barrier and subsequent inflammation can lead to myelin injury and accelerate the progression of vascular dementia.Early activation of microglia is a protective response that contributes to the maintenance of blood-brain barrier integrity through sensing,debris-clearing,and defensive mechanisms.However,prolonged activation can trigger a shift in microglia toward the pro-inflammatory M1 phenotype,resulting in myelin damage and cognitive impairment.Triggering receptor expressed on myeloid cells 2 and triggering receptor expressed on myeloid cells 1 have been identified as potential biomarkers for vascular dementia,as both are closely linked to cognitive decline.Although effective clinical treatments for myelin damage in the central nervous system are currently lacking,researchers are actively working to develop targeted therapies.Several drugs,including nimodipine,dopaminergic agents,simvastatin,biotin,and quetiapine,have been evaluated for clinical use in treating microglial and myelin damage.Future research will face challenges in developing targeted therapeutic strategies for vascular dementia,requiring further investigation into the timing,duration,and specific mechanisms of microglial activation,as well as the exploration of new drug combinations and additional therapeutic targets.展开更多
Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factor...Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factors such as an unhealthy diet,lifestyle,and obesity.Meat products is an important part of the diet of consumers worldwide.This systematic review and meta-analysis aims to assess and estimate the effect of meat products consumption on AD and T2D in humans.Web of Science,MEDLINE,PubMed,Cochrane Library,and Embase were searched from January 2012 to April 2024.29 articles reported 32 cohort studies with 1785769 subjects,with 3546 AD cases and 91092 T2D cases that met the inclusion criteria and were included in our analysis.Consumption of various meat products increased the risk of T2D(hazard ratios(HR)=1.19,95%confidence intervals(CI):1.13−1.26,P=0.000;I2=88.5%),consumption of smoked,grilled/roasted and fried meat products was more likely to induce T2D(HR=1.24,95%CI:1.18−1.30,P=0.000;I2=76.1%),but was borderline significant for the risk of AD(HR=1.11,95%CI:0.98−1.25,P=0.094;I2=58.8%),with consumption of mainly livestock and poultry products increasing the risk(HR=1.21,95%CI:1.03−1.42,P=0.017;I2=66.8%).The association between meat products consumption and AD risk was influenced by meat type and sample size,while the risk of T2D was influenced by meat type,follow-up and sex.A daily intake of 27,123 and 170 g of livestock products increased the risk of T2D by 10%,51%and 70%respectively,whereas the risk of T2D was reduced when the intake of various meat products was less than 23 g/day.展开更多
Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia a...Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.展开更多
OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemic...OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemical composition of TQYZD was analyzed by ultra-high performance liquid chromatography-high resolution mass spectrometry.The effects of TQYZD on VaD rats were evaluated by water maze test,hematoxylin-eosin staining,enzyme-linked immunosorbent assay and Western blot.Untargeted metabolomics and 16S rRNA sequencing were utilized to explore the relationship between metabolic profiles and the structure and function of intestinal flora.Fecal microbiota transplantation(FMT)was used to validate the role of gut microbiota in VaD.Spearman correlation analysis of differential metabolites and gut microbiota was performed.RESULTS:The results showed that TQYZD improved cognitive function and neuronal damage in VaD rats,and reduced inflammatory response and repaired the intestinal barrier.In addition,TQYZD had the effect of modulating gut microbes in VaD rats,and FMT further confirmed that gut flora plays an important role in TQYZD treatment of VaD.Untargeted metabolomics revealed that VaD could lead to metabolic disorders in brain tissues,and TQYZD significantly altered the metabolites of brain tissues in Middle Cerebral Artery Occlusion rats.The results of spearman correlation analysis showed that there was a significant correlation between intestinal flora and the metabolites of brain tissues.CONCLUSION:In this study,we demonstrated that TQYZD can improve metabolic disorders in vascular dementia rats by acting on intestinal flora.展开更多
Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated it...Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated its efficacy in Chinese-speaking populations.This study aimed to assess the effects of a 12-week cognitive stimulation interventiononcognitive functionanddepression inolder adultswithmilddementia.Methods:This quasiexperimental study employed a repeated measures design with a non-randomized experimental and control group.Participants(N=40)65 years and older with mild dementia(clinical dementia rating(CDR)=0.5–1)were recruited from a regional hospital and dementia care center in Taiwan.The experimental group(n=20)received a structured CST intervention for 12 weeks(two sessions per week,120 min per session),while the control group(n=20)received routine care.Cognitive function was assessed using the Saint Louis University Mental Status(SLUMS)exam,and depression was measured using the Chinese version of the Cornell Scale for Depression in Dementia(CSDD-C).Data were collected at baseline,4,8,and 12 weeks and analyzed using repeatedmeasures ANOVA and generalized estimating equation(GEE)modeling.Results:The experimental group showed significant improvements in cognitive function compared to the control group(SLUMS score:baseline 16.1±4.8 to 12th week 19.3±5.0,p<0.001).Depression levels decreased significantly in the experimental group but not in the control group(p<0.05).The GEE analysis showed that the improvement in cognitive function was positively associated with education level and duration,but declined with increasing age.Similarly,depression was lower in participants with higher educational levels and inmen.Conclusions:The findings support the efficacy of CST in improving cognitive function and reducing depression in older adults with mild dementia.The results highlight the importance of the duration of the intervention and individual cognitive reserve in modulating treatment outcomes.展开更多
Background:To understand the current situation of loneliness and dementia fear among elderly people in the community;Analyze the influencing factors and clarify the correlation between the two.Methods:Through convenie...Background:To understand the current situation of loneliness and dementia fear among elderly people in the community;Analyze the influencing factors and clarify the correlation between the two.Methods:Through convenience sampling,228 elderly people were selected as the research subjects,and the general demographic characteristics questionnaire,elderly loneliness scale,dementia fear scale,and simplified intelligence status check scale were used for investigation.SPSS 28.0 statistical software was used for data analysis.Results:The total score of loneliness was 96.21±21.83 points,and the total score of dementia fear was 59.34±13.50 points.There were statistically significant differences in dementia fear scores among elderly people in the community in terms of age,gender,marital status,family history of dementia,and number of chronic diseases(P<0.05).Person correlation analysis showed a positive correlation between the total score of dementia fear and loneliness in elderly people in the community(r=0.162,P<0.05).Conclusion:The level of loneliness and dementia fear among elderly people in the community is at a moderate level.Age,gender,marital status,family history of dementia,and number of chronic diseases are important influencing factors of dementia fear among elderly people in the community.The sense of loneliness among elderly people in the community is positively correlated with dementia fear,meaning that the greater the degree of loneliness,the higher the degree of dementia fear among elderly people in the community.展开更多
Dementia is a neurological disorder that affects the brain and its functioning,and women experience its effects more than men do.Preventive care often requires non-invasive and rapid tests,yet conventional diagnostic ...Dementia is a neurological disorder that affects the brain and its functioning,and women experience its effects more than men do.Preventive care often requires non-invasive and rapid tests,yet conventional diagnostic techniques are time-consuming and invasive.One of the most effective ways to diagnose dementia is by analyzing a patient’s speech,which is cheap and does not require surgery.This research aims to determine the effectiveness of deep learning(DL)and machine learning(ML)structures in diagnosing dementia based on women’s speech patterns.The study analyzes data drawn from the Pitt Corpus,which contains 298 dementia files and 238 control files from the Dementia Bank database.Deep learning models and SVM classifiers were used to analyze the available audio samples in the dataset.Our methodology used two methods:a DL-ML model and a single DL model for the classification of diabetics and a single DL model.The deep learning model achieved an astronomic level of accuracy of 99.99%with an F1 score of 0.9998,Precision of 0.9997,and recall of 0.9998.The proposed DL-ML fusion model was equally impressive,with an accuracy of 99.99%,F1 score of 0.9995,Precision of 0.9998,and recall of 0.9997.Also,the study reveals how to apply deep learning and machine learning models for dementia detection from speech with high accuracy and low computational complexity.This research work,therefore,concludes by showing the possibility of using speech-based dementia detection as a possibly helpful early diagnosis mode.For even further enhanced model performance and better generalization,future studies may explore real-time applications and the inclusion of other components of speech.展开更多
Objective:To explore the application value of the extended nursing intervention mode in senile dementia patients.Methods:A total of 60 cases of Alzheimer’s disease patients were selected as the research subjects and ...Objective:To explore the application value of the extended nursing intervention mode in senile dementia patients.Methods:A total of 60 cases of Alzheimer’s disease patients were selected as the research subjects and divided using the random number table method into the control group and the observation group,each with 30 cases.The control group adopted conventional nursing,while the observation group adopted the extended nursing model of this study.The self-care ability,quality of life,cognitive function,and the frequency of unsafe behaviors were compared between the two groups.Results:After 6 months of intervention,the results showed that the scores of all dimensions in the relevant data tables such as the activity of daily living(ADL)scale,simple intelligence scale,and health survey scale in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of unsafe behaviors in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=5.963,P<0.05).Conclusion:Extended nursing plays a positive role in the nursing of Alzheimer’s patients,including improving their cognitive function and restoring their self-care ability,so as to significantly improve their quality of life and reduce the occurrence of unsafe behaviors.It can be seen that the extended nursing intervention mode can be vigorously promoted in clinical practice.展开更多
BACKGROUND Existing evidence suggests that gut microbiota represent a significant environmental risk factor for various forms of dementia,including Alzheimer's dementia,vascular dementia,and dementia in other dise...BACKGROUND Existing evidence suggests that gut microbiota represent a significant environmental risk factor for various forms of dementia,including Alzheimer's dementia,vascular dementia,and dementia in other diseases classified elsewhere.However,the exact causal relationships between gut microbiota and the different forms of dementia or their subtypes remain unclear.AIM To investigate putative causal relationships between gut microbiota and dementia or its subtypes using Mendelian randomization(MR)analysis.METHODS A bidirectional,two-sample,MR analysis was conducted utilizing publicly available gut microbiota-related genome-wide association study(GWAS)summary data from the MiBioGen consortium alongside GWAS summary statistics for dementia and its subtypes from the FinnGen consortium.Instrumental variables were selected according to the fundamental tenets of MR and their strengths were evaluated using the F-statistic.Five MR methods were employed,and the robustness of our findings was validated.To account for multiple comparisons,we applied the Bonferroni method for P-value adjustment.RESULTS We identified several gut microbiota taxa exhibiting putative causal relationships with dementia or its subtypes,potentially serving as risk or protective factors for the disease.In addition,reverse MR analysis indicated that the relative abundance of several gut microbiota taxa might be influenced by dementia or its subtypes.An exhaustive sensitivity analysis confirmed the absence of heterogeneity and horizontal pleiotropy.After applying correction for multiple testing,we observed that the order Bacillales(odds ratio:0.830,95%confidence interval:0.740-0.932,P=0.00155,Padjust=0.0311)exhibited a strong association with Alzheimer’s disease-related dementia.CONCLUSION The results suggest that gut microbiota is causally associated with dementia.Our findings provide novel insights into the pathophysiology of dementia and have important implications for its treatment and prevention.展开更多
文摘Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2500 g),normal birth weight(2500-3999 g),and macrosomia(≥4000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.
文摘Objective:To translate and adapt the dementia knowledge assessment scale(DKAS)into Sinhala version and to evaluate its psychometric properties among nursing students.Methods:A cross-sectional validation study was conducted in two phases:(i)translation and adaptation and(ii)evaluating psychometric properties(N=394 nursing students).Results:The DKAS was adapted to the Sinhala(Si-DKAS)version,and the content validity index(CVI=0.9)was satisfactory.Exploratory factor analysis(EFA)and confirmatory factor analysis(CFA)resulted in an 18-item Si-DKAS with a four-factor model:“care considerations,”“causes and characteristics of dementia,”“health promotion,”and“misconceptions about dementia.”The model fit indices were suboptimal(comparative fix index[CFI]=0.809 and Turker-Lewis index[TLI]=0.773),and some indices were acceptable(standardized root-mean-squared residual[SRMR]=0.040 and root-mean-squared error of approximation[RMSEA]=0.053).Internal consistency(0.7)and test-retest correlation(0.9)were acceptable.Discriminant validity was confirmed by knowledge score differences based on academic years.Conclusions:This is a valid and reliable tool for assessing knowledge of dementia among Sinhala-speaking nursing students.
基金supported by UKResearch and Innovation(MR/S03546X/1)National BrainAppeal,Economic and Social ResearchCouncil(ES/S010467/1)+4 种基金Wellcome Trust(221915/Z/20/Z),ESRC(ES/W006014/1)Royal National Institute for Deaf People-Dunhill Medical Trust Pauline Ashley(204841/Z/16/Z,PA23)London Hospitals Biomedical Research Centre(221915/Z/20/Z)Bloomsbury and East London Doctoral Training Partnership(ES/P000592/1)National Institute for Health Research.
文摘Rarer dementias are associated with atypical symptoms and younger onset,which result in a higher burden of care.We provide a review of the global literature on longitudinal decline in activities of daily living(ADLs)in dementias that account for less than 10%of dementia diagnoses.Published studies were identified through searches conducted in Medical Literature Analysis and Retrieval System Online(MEDLINE),Excerpta Medica Database(Embase),Excerpta Medica Care(Emcare),PsycINFO,and Cumulative Index in Nursing and Allied Health Literature(CINAHL).The search criteria included terms related to‘rarer dementias’,‘activities of daily living’and‘longitudinal or cross-sectional studies’following a predefined protocol registered.Studies were screened,and those that met the criteria were citation searched.Quality assessments were performed,and relevant data were extracted.20 articles were selected,of which 19 focused on dementias within the frontotemporal dementia/primary progressive aphasia spectrum,while one addressed posterior cortical atrophy.Four studies were cross-sectional and 16 studies were longitudinal,with a median duration of 2.2 years.The Disability Assessment for Dementia was used to measure decline in 8 of the 20 studies.The varied sequences of ADL decline reported in the literature reflect variation in diagnostic specificity between studies and within-syndrome heterogeneity.Most studies used Alzheimer’s disease staging scales to measure decline,which cannot capture variant-specific symptoms.To enhance care provision in dementia,ADL scales could be deployed postdiagnosis to aid treatment and planning.This necessitates staging scales that are variant-specific and span the disease course from diagnosis to end of life.
基金supported by the National Key R&D Program of China,No.2019YFE0121200(to LQZ)the National Natural Science Foundation of China,Nos.82325017(to LQZ),82030032(to LQZ),82261138555(to DL)+2 种基金the Natural Science Foundation of Hubei Province,No.2022CFA004(to LQZ)the Natural Science Foundation of Jiangxi Province,No.20224BAB206040(to XZ)Research Project of Cognitive Science and Transdisciplinary Studies Center of Jiangxi Province,No.RZYB202201(to XZ).
文摘With an increase in global aging,the number of people affected by cerebrovascular diseases is also increasing,and the incidence of vascular dementia-closely related to cerebrovascular risk-is increasing at an epidemic rate.However,few therapeutic options exist that can markedly improve the cognitive impairment and prognosis of vascular dementia patients.Similarly in Alzheimer’s disease and other neurological disorders,synaptic dysfunction is recognized as the main reason for cognitive decline.Nitric oxide is one of the ubiquitous gaseous cellular messengers involved in multiple physiological and pathological processes of the central nervous system.Recently,nitric oxide has been implicated in regulating synaptic plasticity and plays an important role in the pathogenesis of vascular dementia.This review introduces in detail the emerging role of nitric oxide in physiological and pathological states of vascular dementia and summarizes the diverse effects of nitric oxide on different aspects of synaptic dysfunction,neuroinflammation,oxidative stress,and blood-brain barrier dysfunction that underlie the progress of vascular dementia.Additionally,we propose that targeting the nitric oxide-sGC-cGMP pathway using certain specific approaches may provide a novel therapeutic strategy for vascular dementia.
基金Supported by National Natural Science Foundation of China (General Program),No.32060182Qiannan Prefecture Science and Technology Plan Project in China,No.Qiannan Kehe She Zi[2022]No.1.
文摘Dementia is a group of diseases,including Alzheimer's disease(AD),vascular dementia,Lewy body dementia,frontotemporal dementia,Parkinson's disease dementia,metabolic dementia and toxic dementia.The treatment of dementia mainly includes symptomatic treatment by controlling the primary disease and accompanying symptoms,nutritional support therapy for repairing nerve cells,psychological auxiliary treatment,and treatment that improves cognitive function through drugs.Among them,drug therapy to improve cognitive function is important.This review focuses on introducing and commenting on some recent progress in exploring drugs to improve cognitive function,especially the new progress in drug treatment for AD.We mainly discuss the opportunities and challenges in finding and developing new therapeutic drugs from the aspects of acetylcholinesterase,N-methyl-D-aspartate glutamate receptor,amyloid protein,tau protein and chronic immune inflammation.
基金supported by the Strategic Research and Consulting Project of the Chinese Academy of Engineering(Nos.2023-XZ-43 and 2023-PP-05).
文摘China is facing a rapidly aging population,significantly impacting public health and healthcare systems.According to the"National Report on the Development of Undertakings for the Aged(2022),"there are 280 million people aged 60 years and above in China,accounting for 19.8%of the total population(Fig.1A)[1].This percentage has steadily increased from 14.3%in 2012.Projections indicate that by 2050,the elderly population in China will peak at approximately 487 million,representing 34.9%of the total population[2].In this perspective article,we analyze the current challenges facing China's dementia prevention and control system,with the aim of presenting policy recommendations to effectively address these issues.
基金supported by the National Natural Science Foundation of China(Grant Nos.62071451,62331025,and U21A20447)the National Key Research and Development Project(Grant No.2021YFC3002204)the CAMS Innovation Fund for Medical Sciences(Grant No.2019-I2M-5-019).
文摘Dementias such as Alzheimer disease(AD)and mild cognitive impairment(MCI)lead to problems with memory,language,and daily activities resulting from damage to neurons in the brain.Given the irreversibility of this neuronal damage,it is crucial to find a biomarker to distinguish individuals with these diseases from healthy people.In this study,we construct a brain function network based on electroencephalography data to study changes in AD and MCI patients.Using a graph-theoretical approach,we examine connectivity features and explore their contributions to dementia recognition at edge,node,and network levels.We find that connectivity is reduced in AD and MCI patients compared with healthy controls.We also find that the edge-level features give the best performance when machine learning models are used to recognize dementia.The results of feature selection identify the top 50 ranked edge-level features constituting an optimal subset,which is mainly connected with the frontal nodes.A threshold analysis reveals that the performance of edge-level features is more sensitive to the threshold for the connection strength than that of node-and network-level features.In addition,edge-level features with a threshold of 0 provide the most effective dementia recognition.The K-nearest neighbors(KNN)machine learning model achieves the highest accuracy of 0.978 with the optimal subset when the threshold is 0.Visualization of edge-level features suggests that there are more long connections linking the frontal region with the occipital and parietal regions in AD and MCI patients compared with healthy controls.Our codes are publicly available at https://github.com/Debbie-85/eeg-connectivity.
基金Supported by The National Natural Science Foundation of China Young Scientists Fund:82004480。
文摘Objective:This study aimed to observe the effects of xiusanzhen acupuncture(olfactory three-needling therapy)on the behavior,hippocampal histopathology and microglial(MG)activation of rats with vascular dementia(VD),and to assess the role of the trigeminal nerve.Methods:Sprague-Dawley(SD)rats were randomly assigned to the sham-operation,model,xiusanzhen,and trigeminal neurotomy groups(n=15 per group).Bilateral common carotid artery ligation was performed to prepare the VD models.Models of trigeminal neurotomy were prepared through the excision of the frontal nerve and infraorbital nerve.Xiusanzhen acupuncture was delivered via electric stimulation.The acupoints selected were bilateral“Yingxiang(LI20)”and“Yintang(EX-HN3)”,and the stimulation parameters were as follows:disperse-dense wave,at a frequency of 2/15HZ and intensity of 1 mA.The course of treatment was once daily,with one course lasting five days,followed by an interval of two days,yielding a total of four courses.Behavioral changes were detected using the Morris water maze,changes in histomorphology in the hippocampal CA1 region were determined with hematoxylin and eosin(HE)staining,and MG activation in the hippocampal CA1 region was detected using immunofluorescence.Results:The escape latency:From days 3 to 5,the escape latency was higher in the model group compared to the sham-operation group(P<0.05),but was lower in the xiusanzhen group compared to the model and trigeminal neurotomy groups(P<0.05).The frequency for platform crossing and swimming distance:both were reduced in the model group compared to the sham-operation group(P<0.01);and were elevated in the xiusanzhen group compared to the model group and trigeminal neurotomy group(P<0.01).Hippocampal pathomorphological changes:In the sham-operation group,the morphological structure and nucleoli were well-defined;in the model group and the trigeminal neurotomy group,cell numbers were reduced and karyopyknosis increased;while in the xiusanzhen group,the cell numbers were elevated and karyopyknosis was reduced compared with the model group.MG:the positive rate was higher in the model group compared to the sham-operation group(P<0.05);lower in the xiusanzhen group compared to the model group(P<0.05);and higher in the trigeminal neurotomy group compared to the xiusanzhen group(P<0.05).Conclusion:Xiusanzhen acupuncture attenuates cognitive impairment in VD rats,inhibits MG activation,and reduces hippocampal tissue damage.Its effects depend on the structural integrity of the trigeminal nerve.
基金supported by the Fundamental Research Funds for the Central Universities(lzujbky-2022-it36)。
文摘Objective:To clarify the concept of in-home respite care in dementia care and identify changes in the service content over time to help providers and users better understand this sustainable service.Method:A literature search was conducted through Chinese databases China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and SinoMed,as well as English databases PubMed,the Cochrane Library,Web of Sciences,and Embase.Articles published from January 1980 to December 2024 were identified.Rogers’conceptual analysis of evolution was used for this concept analysis,including six steps:identifying the concept and its context,selecting appropriate databases,determining relevant literature,identifying the concept’s attributes,antecedents,and consequences,choosing a concept exemplar if appropriate,and defininghypotheses and implications for further concept development.Results:Thirty-one articles were included.This conceptual analysis revealed the evolution of in-home respite care service content over time and summarized three key attributes.The antecedents included factors related to people with dementia,family caregivers,and the social environment(aging society,government support).The consequences of in-home respite services include delayed institutional placement and reduced security risk events for people with dementia.For family caregivers,consequences include reduced caregiving stress,improved quality of life,and perceived benefitsfrom rest periods.Conclusion:In-home respite care can be interpreted as family-centered home care that provides temporary relief from family caregivers’responsibilities in caring for people with dementia to reduce caregiver burden.The trend of service specialization and attention on dementia families’needs in service provision are future research focus.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
文摘Objective To investigate the effects of WenFei JiangZhuo Formula on cognitive function,serum neurofactors,and cerebral blood flow status in patients with mild-to-moderate vascular dementia(VaD),providing evidence for clinical treatment.Methods A total of 80 patients with mild-to-moderate VaD admitted to our hospital from January 2022 to December 2023 were randomly divided into a control group(40 cases)and an observation group(40 cases)using a random number table.The control group received oral administration of butylphenidyl soft capsules,while the observation group received WenFei JiangZhuo Formula decoction as adjunct therapy.Both groups underwent continuous treatment for 12 weeks.Clinical outcomes were compared including cognitive function scores(MMSE,MoCA),serum neurofactors[brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],and cerebral hemodynamics parameters[peak systolic velocity(Vs),end-diastolic velocity(Vd),mean velocity(Vm)of the middle cerebral artery(MCA)and anterior cerebral artery(ACA)].Clinical efficacy and adverse reactions were statistically analyzed.Results:After treatment,both groups showed significantly improved MMSE and MoCA scores compared to baseline levels(P<0.05),with the observation group demonstrating greater improvement than the control group(P<0.05).Serum BDNF and NGF levels increased significantly in both groups(P<0.05),while TNF-αand IL-6 levels decreased markedly(P<0.05),with the observation group showing better improvement than the control group(P<0.05).Both groups showed significant increases in MCA,ACA,Vs,Vd,and Vm compared to baseline levels(P<0.05),with the observation group outperforming the control group(P<0.05).The overall effective rate in the observation group was 87.50%,significantly higher than the control group's 67.50%(P<0.05).No statistically significant differences were observed in adverse reaction rates between the groups(P>0.05).Conclusion:WenFei JiangZhuo Formula can effectively improve cognitive function in patients with mild-to-moderate VaD.This mechanism may involve upregulating neurotrophic factors,suppressing inflammatory responses,and enhancing cerebral blood flow perfusion,with demonstrated safety profile.
基金supported by the Natural Science Foundation of Beijing,No.7232279(to XW)the National Natural Science Foundation of China,No.U21A20400(to QW)Key Project of Beijing University of Chinese Medicine,Nos.2022-JYB-JBZR-004(to XW),2024-JYB-JBZD-043(to CL).
文摘Chronic cerebral hypoperfusion can lead to neuronal necrosis,trigger inflammatory responses,promote white matter damage,and ultimately result in cognitive impairment.Consequently,chronic cerebral hypoperfusion is an important factor influencing the onset and progression of vascular dementia.The myelin sheath is a critical component of white matter,and damage and repair of the white matter are closely linked to myelin sheath integrity.This article reviews the role of microglia in vascular dementia,focusing on their effects on myelin sheaths and the potential therapeutic implications.The findings suggest that ischemia and hypoxia cause disruption of the blood-brain barrier and activate microglia,which may worsen blood-brain barrier damage through the release of matrix-degrading enzymes.Microglia-mediated metabolic reprogramming is recognized as an important driver of inflammation.Damage to the blood-brain barrier and subsequent inflammation can lead to myelin injury and accelerate the progression of vascular dementia.Early activation of microglia is a protective response that contributes to the maintenance of blood-brain barrier integrity through sensing,debris-clearing,and defensive mechanisms.However,prolonged activation can trigger a shift in microglia toward the pro-inflammatory M1 phenotype,resulting in myelin damage and cognitive impairment.Triggering receptor expressed on myeloid cells 2 and triggering receptor expressed on myeloid cells 1 have been identified as potential biomarkers for vascular dementia,as both are closely linked to cognitive decline.Although effective clinical treatments for myelin damage in the central nervous system are currently lacking,researchers are actively working to develop targeted therapies.Several drugs,including nimodipine,dopaminergic agents,simvastatin,biotin,and quetiapine,have been evaluated for clinical use in treating microglial and myelin damage.Future research will face challenges in developing targeted therapeutic strategies for vascular dementia,requiring further investigation into the timing,duration,and specific mechanisms of microglial activation,as well as the exploration of new drug combinations and additional therapeutic targets.
基金supported by the Agricultural Science and Technology Innovation Program,Institute of Food Science and Technology,Chinese Academy of Agricultural Sciences under Grant CAAS-ASTIP-2023-IFSTGuangdong Provincial Key R&D Programme(2023B0202080003).
文摘Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factors such as an unhealthy diet,lifestyle,and obesity.Meat products is an important part of the diet of consumers worldwide.This systematic review and meta-analysis aims to assess and estimate the effect of meat products consumption on AD and T2D in humans.Web of Science,MEDLINE,PubMed,Cochrane Library,and Embase were searched from January 2012 to April 2024.29 articles reported 32 cohort studies with 1785769 subjects,with 3546 AD cases and 91092 T2D cases that met the inclusion criteria and were included in our analysis.Consumption of various meat products increased the risk of T2D(hazard ratios(HR)=1.19,95%confidence intervals(CI):1.13−1.26,P=0.000;I2=88.5%),consumption of smoked,grilled/roasted and fried meat products was more likely to induce T2D(HR=1.24,95%CI:1.18−1.30,P=0.000;I2=76.1%),but was borderline significant for the risk of AD(HR=1.11,95%CI:0.98−1.25,P=0.094;I2=58.8%),with consumption of mainly livestock and poultry products increasing the risk(HR=1.21,95%CI:1.03−1.42,P=0.017;I2=66.8%).The association between meat products consumption and AD risk was influenced by meat type and sample size,while the risk of T2D was influenced by meat type,follow-up and sex.A daily intake of 27,123 and 170 g of livestock products increased the risk of T2D by 10%,51%and 70%respectively,whereas the risk of T2D was reduced when the intake of various meat products was less than 23 g/day.
基金supported by the Major Programs of Public Health of the Chinese Ministry of Finance(grant number 131091106000150003)。
文摘Objective The results of limited studies on the relationship between environmental pollution and dementia have been contradictory.We analyzed the combined effects of PM_(2.5)and smoking on the prevalence of dementia and cognitive impairment in an elderly community-dwelling Chinese population.Methods We assessed 24,117 individuals along with the annual average PM_(2.5)concentrations from 2012 to 2016.Dementia was confirmed in the baseline survey at a qualified clinical facility,and newly suspected dementia was assessed in 2017,after excluding cases of suspected dementia in 2015.National census data were used to weight the sample data to reflect the entire population in China,with multiple logistic regression performed to analyze the combined effects of PM_(2.5)and smoking frequency on dementia and cognitive impairment.Results Individuals exposed to the highest PM_(2.5)concentration and smoked daily were at higher risk of dementia than those in the lowest PM_(2.5)concentration group(OR,1.603;95%CI[1.626−1.635],P<0.0001)and in the nonsmoking group(OR,1.248;95%CI[1.244−1.252];P<0.0001).Moderate PM_(2.5)exposure and occasional smoking together increased the short-term risk of cognitive impairment.Highlevel PM_(2.5)exposure and smoking were associated with an increased risk of dementia,so more efforts are needed to reduce this risk through environmental protection and antismoking campaigns.Conclusion High-level PM_(2.5)exposure and smoking were associated with an increased risk of dementia.Lowering the ambient PM_(2.5),and smoking cessation are recommended to promote health.
基金Supported by the Southwest Medical University Project:Exploring the Neuroprotective Mechanism of Tongqiao Yizhi Decoction on Vascular Dementia Rats Based on the Brain Gut Axis(southwest Medical University[2021]No.1)。
文摘OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemical composition of TQYZD was analyzed by ultra-high performance liquid chromatography-high resolution mass spectrometry.The effects of TQYZD on VaD rats were evaluated by water maze test,hematoxylin-eosin staining,enzyme-linked immunosorbent assay and Western blot.Untargeted metabolomics and 16S rRNA sequencing were utilized to explore the relationship between metabolic profiles and the structure and function of intestinal flora.Fecal microbiota transplantation(FMT)was used to validate the role of gut microbiota in VaD.Spearman correlation analysis of differential metabolites and gut microbiota was performed.RESULTS:The results showed that TQYZD improved cognitive function and neuronal damage in VaD rats,and reduced inflammatory response and repaired the intestinal barrier.In addition,TQYZD had the effect of modulating gut microbes in VaD rats,and FMT further confirmed that gut flora plays an important role in TQYZD treatment of VaD.Untargeted metabolomics revealed that VaD could lead to metabolic disorders in brain tissues,and TQYZD significantly altered the metabolites of brain tissues in Middle Cerebral Artery Occlusion rats.The results of spearman correlation analysis showed that there was a significant correlation between intestinal flora and the metabolites of brain tissues.CONCLUSION:In this study,we demonstrated that TQYZD can improve metabolic disorders in vascular dementia rats by acting on intestinal flora.
基金supported by a grant from Chung Shan Medical University(Grant No.:CSMUINT-109-06).
文摘Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated its efficacy in Chinese-speaking populations.This study aimed to assess the effects of a 12-week cognitive stimulation interventiononcognitive functionanddepression inolder adultswithmilddementia.Methods:This quasiexperimental study employed a repeated measures design with a non-randomized experimental and control group.Participants(N=40)65 years and older with mild dementia(clinical dementia rating(CDR)=0.5–1)were recruited from a regional hospital and dementia care center in Taiwan.The experimental group(n=20)received a structured CST intervention for 12 weeks(two sessions per week,120 min per session),while the control group(n=20)received routine care.Cognitive function was assessed using the Saint Louis University Mental Status(SLUMS)exam,and depression was measured using the Chinese version of the Cornell Scale for Depression in Dementia(CSDD-C).Data were collected at baseline,4,8,and 12 weeks and analyzed using repeatedmeasures ANOVA and generalized estimating equation(GEE)modeling.Results:The experimental group showed significant improvements in cognitive function compared to the control group(SLUMS score:baseline 16.1±4.8 to 12th week 19.3±5.0,p<0.001).Depression levels decreased significantly in the experimental group but not in the control group(p<0.05).The GEE analysis showed that the improvement in cognitive function was positively associated with education level and duration,but declined with increasing age.Similarly,depression was lower in participants with higher educational levels and inmen.Conclusions:The findings support the efficacy of CST in improving cognitive function and reducing depression in older adults with mild dementia.The results highlight the importance of the duration of the intervention and individual cognitive reserve in modulating treatment outcomes.
文摘Background:To understand the current situation of loneliness and dementia fear among elderly people in the community;Analyze the influencing factors and clarify the correlation between the two.Methods:Through convenience sampling,228 elderly people were selected as the research subjects,and the general demographic characteristics questionnaire,elderly loneliness scale,dementia fear scale,and simplified intelligence status check scale were used for investigation.SPSS 28.0 statistical software was used for data analysis.Results:The total score of loneliness was 96.21±21.83 points,and the total score of dementia fear was 59.34±13.50 points.There were statistically significant differences in dementia fear scores among elderly people in the community in terms of age,gender,marital status,family history of dementia,and number of chronic diseases(P<0.05).Person correlation analysis showed a positive correlation between the total score of dementia fear and loneliness in elderly people in the community(r=0.162,P<0.05).Conclusion:The level of loneliness and dementia fear among elderly people in the community is at a moderate level.Age,gender,marital status,family history of dementia,and number of chronic diseases are important influencing factors of dementia fear among elderly people in the community.The sense of loneliness among elderly people in the community is positively correlated with dementia fear,meaning that the greater the degree of loneliness,the higher the degree of dementia fear among elderly people in the community.
基金funded by the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University,through the Research Groups Program Grant No.(RGP-1444-0057).
文摘Dementia is a neurological disorder that affects the brain and its functioning,and women experience its effects more than men do.Preventive care often requires non-invasive and rapid tests,yet conventional diagnostic techniques are time-consuming and invasive.One of the most effective ways to diagnose dementia is by analyzing a patient’s speech,which is cheap and does not require surgery.This research aims to determine the effectiveness of deep learning(DL)and machine learning(ML)structures in diagnosing dementia based on women’s speech patterns.The study analyzes data drawn from the Pitt Corpus,which contains 298 dementia files and 238 control files from the Dementia Bank database.Deep learning models and SVM classifiers were used to analyze the available audio samples in the dataset.Our methodology used two methods:a DL-ML model and a single DL model for the classification of diabetics and a single DL model.The deep learning model achieved an astronomic level of accuracy of 99.99%with an F1 score of 0.9998,Precision of 0.9997,and recall of 0.9998.The proposed DL-ML fusion model was equally impressive,with an accuracy of 99.99%,F1 score of 0.9995,Precision of 0.9998,and recall of 0.9997.Also,the study reveals how to apply deep learning and machine learning models for dementia detection from speech with high accuracy and low computational complexity.This research work,therefore,concludes by showing the possibility of using speech-based dementia detection as a possibly helpful early diagnosis mode.For even further enhanced model performance and better generalization,future studies may explore real-time applications and the inclusion of other components of speech.
文摘Objective:To explore the application value of the extended nursing intervention mode in senile dementia patients.Methods:A total of 60 cases of Alzheimer’s disease patients were selected as the research subjects and divided using the random number table method into the control group and the observation group,each with 30 cases.The control group adopted conventional nursing,while the observation group adopted the extended nursing model of this study.The self-care ability,quality of life,cognitive function,and the frequency of unsafe behaviors were compared between the two groups.Results:After 6 months of intervention,the results showed that the scores of all dimensions in the relevant data tables such as the activity of daily living(ADL)scale,simple intelligence scale,and health survey scale in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of unsafe behaviors in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=5.963,P<0.05).Conclusion:Extended nursing plays a positive role in the nursing of Alzheimer’s patients,including improving their cognitive function and restoring their self-care ability,so as to significantly improve their quality of life and reduce the occurrence of unsafe behaviors.It can be seen that the extended nursing intervention mode can be vigorously promoted in clinical practice.
基金Supported by Science and Technology Planning Project of Zhanjiang,No.2021A05071Clinic and Basic Research Project of Guangdong Medical University,No.4SG23284GThe Affiliated Hospital of Guangdong Medical University,No.LCYJ2018A003.
文摘BACKGROUND Existing evidence suggests that gut microbiota represent a significant environmental risk factor for various forms of dementia,including Alzheimer's dementia,vascular dementia,and dementia in other diseases classified elsewhere.However,the exact causal relationships between gut microbiota and the different forms of dementia or their subtypes remain unclear.AIM To investigate putative causal relationships between gut microbiota and dementia or its subtypes using Mendelian randomization(MR)analysis.METHODS A bidirectional,two-sample,MR analysis was conducted utilizing publicly available gut microbiota-related genome-wide association study(GWAS)summary data from the MiBioGen consortium alongside GWAS summary statistics for dementia and its subtypes from the FinnGen consortium.Instrumental variables were selected according to the fundamental tenets of MR and their strengths were evaluated using the F-statistic.Five MR methods were employed,and the robustness of our findings was validated.To account for multiple comparisons,we applied the Bonferroni method for P-value adjustment.RESULTS We identified several gut microbiota taxa exhibiting putative causal relationships with dementia or its subtypes,potentially serving as risk or protective factors for the disease.In addition,reverse MR analysis indicated that the relative abundance of several gut microbiota taxa might be influenced by dementia or its subtypes.An exhaustive sensitivity analysis confirmed the absence of heterogeneity and horizontal pleiotropy.After applying correction for multiple testing,we observed that the order Bacillales(odds ratio:0.830,95%confidence interval:0.740-0.932,P=0.00155,Padjust=0.0311)exhibited a strong association with Alzheimer’s disease-related dementia.CONCLUSION The results suggest that gut microbiota is causally associated with dementia.Our findings provide novel insights into the pathophysiology of dementia and have important implications for its treatment and prevention.
