Background As the population in China rapidly ages,the prevalence of mild cognitive impairment(MCI)is increasing considerably.However,the causes of MCI vary.The continued lack of understanding of the various subtypes ...Background As the population in China rapidly ages,the prevalence of mild cognitive impairment(MCI)is increasing considerably.However,the causes of MCI vary.The continued lack of understanding of the various subtypes of MCI impedes the implementation of effective measures to reduce the risk of advancing to more severe cognitive diseases.Aims To estimate the prevalence and incidence rates of two MCI subtypes—amnestic MCI(aMCI)and vascular cognitive impairment without dementia(VCIND)—and to determine modifiable factors for them among older individuals in a multiregional Chinese cohort.Method This 1-year longitudinal study surveyed a random sample of participants aged≥60 years from a large,community-dwelling cohort in China.Baseline lifestyle data were self-reported,while vascular and comorbid conditions were obtained from medical records and physical examinations.In total,3514 and 2051 individuals completed the baseline and 1-year follow-up assessments,respectively.Logistic and linear regression analyses were used to identify the modifiable factors for MCI subtypes and predictors of cognitive decline,respectively.Results Among our participants,aMCI and VCIND demonstrated prevalence of 14.83%and 2.71%,respectively,and annual incidence(per 1000 person-years)of 69.6 and 10.6,respectively.The risk factor for aMCI was age,whereas its protective factors were high education level,tea consumption and physical activity.Moreover,VCIND risk factors were age,hypertension and depression.The presence of endocrine disease,cerebral trauma or hypertension was associated with a faster decline in cognition over 1 year.Conclusions MCI is a serious health problem in China that will only worsen as the population ages if no widespread interventions are implemented.Preventive strategies that promote brain activity and support healthy lifestyle choices are required.We identified modifiable factors for MCI in older individuals.The easy-to-adopt solutions such as tea consumption and physical activity can aid in preventing MCI.展开更多
Background Schizophrenia is characterised by pervasive cognitive deficits that significantly impair daily functioning and quality of life.Pharmacological treatments have limited efficacy in addressing these deficits,h...Background Schizophrenia is characterised by pervasive cognitive deficits that significantly impair daily functioning and quality of life.Pharmacological treatments have limited efficacy in addressing these deficits,highlighting the need for adjunctive interventions like computerised cognitive training(CCT).Aims This study aimed to evaluate the effects of a 30-session CCT programme on mental well-being and cognitive performance in individuals with schizophrenia.Additionally,it assessed the usability and acceptability of CCT in this population.Methods A double-blind,randomised clinical trial was conducted with 54 participants assigned to intervention and control groups.Cognitive and mental health outcomes were assessed using validated tools such as the Depression Anxiety Stress Scale 21,the Warwick-Edinburgh Mental Wellbeing Scale and the Cambridge Neuropsychological Test Automated Battery.Usability was measured with the System Usability Scale(SUS).Assessments were conducted at baseline,post-intervention and 3 months post-follow-up.Results The CCT intervention significantly improved mental well-being,reduced stress and enhanced working memory(paired associate learning,spatial working memory and spatial span)compared with controls.However,no significant effects were observed for anxiety,depression or executive function.Usability scores were high(SUS=83.51),and compliance rates were strong(92.7%),indicating favourable participant engagement.Conclusion CCT demonstrated potential as an adjunctive treatment for schizophrenia,with significant improvements in targeted cognitive and mental health domains.The high usability and compliance rates support its feasibility for broader implementation.Further research is needed to optimise protocols and explore long-term benefits.CCT offers a promising approach to addressing mental health and cognitive challenges in schizophrenia,particularly for stress and working memory.Its usability and acceptability suggest it could be seamlessly integrated into clinical practice.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
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
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
According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(C...According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.展开更多
Cognitive bias,stemming from electronic measurement error and variability in human perception,exists in cognitive electronic warfare and affects the outcomes of conflicts.In this paper,the dynamic game approach is emp...Cognitive bias,stemming from electronic measurement error and variability in human perception,exists in cognitive electronic warfare and affects the outcomes of conflicts.In this paper,the dynamic game approach is employed to develop a model for cognitive bias induced by incomplete information and measurement errors in cognitive radar countermeasures.The payoffs for both parties are calculated using the radar's anti-jamming strategy matrix A and the jammer's jamming strategy matrix B.With perfect Bayesian equilibrium,a dynamic radar countermeasure model is established,and the impact of cognitive bias is analyzed.Drawing inspiration from the cognitive bias analysis method used in stock market trading,a cognitive bias model for cognitive radar countermeasures is introduced,and its correctness is mathematically proved.A gaming scenario involving the AN/SPY-1 radar and a smart jammer is set up to analyze the influence of cognitive bias on game outcomes.Simulation results validate the effectiveness of the proposed method.展开更多
Muñoz Zamora et al.'s study^([1])is the first to investigate how cognitive processes can directly affect thermoregulation.By combining behavioral conditioning,engram labeling,and neural manipulation technique...Muñoz Zamora et al.'s study^([1])is the first to investigate how cognitive processes can directly affect thermoregulation.By combining behavioral conditioning,engram labeling,and neural manipulation techniques,the authors demonstrate that mice are capable of can form and retrieve memories of cold environments.Remarkably,recalling these memories induces metabolic responses typically associated with actual cold exposure.This work represents a significant advancement in our understanding of brain,body interactions,particularly in how learned experiences can modulate fundamental homeostatic processes.The findings have broad implications across multiple fields of neuroscience and physiology.展开更多
The concept of the brain cognitive reserve is derived from the well-acknowledged notion that the degree of brain damage does not always match the severity of clinical symptoms and neurological/cognitive outcomes.It ha...The concept of the brain cognitive reserve is derived from the well-acknowledged notion that the degree of brain damage does not always match the severity of clinical symptoms and neurological/cognitive outcomes.It has been suggested that the size of the brain(brain reserve) and the extent of neural connections acquired through life(neural reserve) set a threshold beyond which noticeable impairments occur.In contrast,cognitive reserve refers to the brain's ability to adapt and reo rganize stru cturally and functionally to resist damage and maintain function,including neural reserve and brain maintenance,resilience,and compensation(Verkhratsky and Zorec,2024).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
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 Group cognitive behavioral therapy(GCBT)is increasingly being used to treat obsessive-compulsive disorder(OCD)because of its high efficiency,economy,and interaction among group members.However,the changes i...BACKGROUND Group cognitive behavioral therapy(GCBT)is increasingly being used to treat obsessive-compulsive disorder(OCD)because of its high efficiency,economy,and interaction among group members.However,the changes in network functional connectivity(FC)in patients with OCD with GCBT remain unclear.AIM To investigate inter-and intra-network resting-state FC(rs-FC)abnormalities before and after GCBT in unmedicated patients with OCD and validate the efficacy of GCBT.METHODS Overall,33 individuals with OCD and 26 healthy controls underwent resting-state functional magnetic resonance imaging.The patients were rescanned 12 weeks after GCBT.Four cognition-related networks-default mode network(DMN),dorsal attention network(DAN),salience network(SAN),and frontoparietal network(FPN)-were selected to examine FC abnormalities within and between OCD networks before and after GCBT.Neuropsychological assessments including memory,executive function,speech,attention,and visuospatial ability were reassessed following GCBT.Pearson’s correlations were used to analyze the relationship between aberrant FC in cognition-related networks and altered neuropsychological assessments in patients.RESULTS Rs-FC within the DMN and DAN decreased significantly.Additionally,rs-FC between the DMN-DAN,DMNFPN,DMN-SAN,and DAN-SAN also decreased.Significant improvements were observed in cognitive functions,such as memory,executive function,attention,and visuospatial ability.Furthermore,reduced rs-FC within the DMN correlated with visuospatial ability and executive function;DAN positively correlated with Shape Trails Test(STT)-A test elapsed time;DMN-DAN negatively correlated with Rey-Osterrieth Complex Figure(Rey-O)mimicry time and the three elapsed times of the tower of Hanoi;DMN-SAN negatively correlated with Rey-O imitation time and positively correlated with STT-A test elapsed time;and DMN-FPN negatively correlated with Auditory Word Learning Test N1 and N4 scores.CONCLUSION Decreased rs-FC within the DMN and DAN,which correlated with executive function post-treatment,has potential as a neuroimaging marker to predict treatment response to GCBT in patients with OCD.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 Major depressive disorder(MDD)and bipolar depression(BD-D)are both intricate,enduring,and profound psychiatric conditions characterized primarily by depressive episodes and cognitive dysfunction.However,dis...BACKGROUND Major depressive disorder(MDD)and bipolar depression(BD-D)are both intricate,enduring,and profound psychiatric conditions characterized primarily by depressive episodes and cognitive dysfunction.However,distinguishing the characteristics and influencing factors of cognitive impairment in unipolar and BD-D is crucial for identification and intervention.AIM To compare neurocognitive characteristics and investigate associations between cognitive function and clinical features in unipolar and BD-D.METHODS The THINC-integrated tool(THINC-it)as a cognitive assessment tool was applied to 295 individuals:75 patients with depressive disorders(MDD),120 individuals with BD-D,and 100 healthy controls.The Hamilton Depression Scale-17(HAMD),Hamilton Anxiety Scale-14(HAMA),and Pittsburgh Sleep Quality Index(PSQI)were employed to assess depression,anxiety,and sleep.Neurocognitive function characteristics and the relationships between cognitive impairment and general clinical attributes were analyzed.RESULTS There were no statistically significant differences in the overall THINC-it with each objective subscale.However,the subjective subscale(Perceived Deficits Questionnaire for Depression-5-item)showed significant differences between MDD and BD-D(P<0.001).Linear regression analyses were explored to determine associations.Age,years of education,age at onset,and HAMD were significantly co-associated with the overall THINC-it and each subscale in both MDD and BD-D(P<0.05).Furthermore,years of education showed a positive correlation with objective cognitive impairment(e.g.,Codebreaker,Trails)(P<0.05).There was a notable difference in that the number of depressive episodes,disease duration,hospitalizations,HAMA,and PSQI were significantly associated with the overall THINC-it with each subscale between MDD and BD-D(P<0.05).CONCLUSION Although both unipolar and BD-D showed similar objective cognitive impairments,there was a significant difference in subjective cognitive impairment.Our findings suggest that factors like age,years of education,age at onset,and depression severity might not be significantly difference in the influence of cognitive impairment.Furthermore,we found that education was a protective factor for cognitive impairment in both unipolar and BD-D.Our analysis revealed that distinct factors including disease duration,number of depressive episodes,hospitalizations,anxiety levels,and sleep quality influenced cognitive impairment between unipolar and BD-D.Therefore,it was important to investigate the specific characteristics of cognitive impairment and influencing factors to identify differentiating unipolar and BD-D.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
BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal med...BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal medicine for cognitive impairment;yet,clinical research on acupotomy is lacking.Although most TKM treatments occur in primary care,the research is largely hospital-based.This registry was established to systematically collect real-world data on the clinical progress,efficacy,and safety of TKM with acupotomy for patients with MCI or SCD in primary care.It is hypothesized that TKM with acupotomy improves cognitive function and is safe for these patients.AIM To establish an MCI or SCD registry of patients receiving TKM,including acupotomy,to analyze its clinical efficacy and safety.METHODS This observational registry study will be conducted across 22 medical institutions;approximately 500 participants will be recruited.Data—sociodemographic information,medication history,height,weight,vital signs,and assessment questionnaires(Montreal Cognitive Assessment-Korean,short form of Korean-Everyday Cognition,Numeric Rating Scale,Korean version of the Insomnia Severity Index)—will be collected at 3-month intervals over a year.This study will also document the TKM treatment administered and any adverse events.Routine TKM procedures will be followed,with acupuncture and acupotomy administered as per protocol;treatments including herbal medicine,Chuna therapy,and moxibustion may be administered at the practitioner’s discretion.RESULTS The registry will capture a wide range of real-world clinical data regarding demographic profiles,treatment processes,and adverse events.This detailed documentation is expected to clarify patient characteristics,evaluate the clinical course,and identify factors that may affect cognitive improvement in patients with MCI and SCD.CONCLUSION This research may provide evidence supporting acupotomy for cognitive impairment in primary care by confirming its efficacy and safety,providing preliminary evidence for TKM-based interventions aimed at improving cognitive function.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 Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To i...BACKGROUND Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in patients with MCI.METHODS This retrospective analysis involved 180 patients with MCI who were admitted to The First Hospital of Shanxi Medical University from January 2021 to June 2023.Participants were allocated into the research(n=98,receiving rTMS)and control groups(n=82,receiving sham stimulation).Memory tests,cognitive function assessments,event-related potential–P300 tests,and electroencephalogram(EEG)examinations were conducted pre-treatment and post-treatment.Further,memory quotient(MQ),cognitive function scores,and EEG grading results were compared,along with adverse reaction incidences.RESULTS Pre-treatment MQ scores,long-term and short-term memory,as well as immediate memory scores,demonstrated no notable differences between the groups.Post-treatment,the research group exhibited significant increases in MQ scores,long-term memory,and short-term memory compared to baseline(P<0.05),with these improvements being statistically superior to those in the control group.However,immediate memory scores exhibited no significant change(P>0.05).Further,the research group demonstrated statistically better post-treatment scores on the Revised Wechsler Memory Scale than the control group.Furthermore,post-treatment P300 latency and amplitude improved significantly in the research group,surpassing the control group.EEG grading in the research group improved,and the incidence of adverse reactions was significantly lower than in the control group.CONCLUSION Patients with MCI receiving rTMS therapy demonstrated improved memory and cognitive functions and EEG grading and exhibited high safety with fewer adverse reactions.展开更多
Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)...Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.展开更多
Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a sign...Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.展开更多
基金supported by the Major Project of Wuxi Municipal Health Commission[grant number:Z202406]the Jiangsu Commission of Health Program[grant number:M2024010]+3 种基金the National Key Research and Development Program[grant number:2022YFC3600600]the China Ministry of Science and Technology grants[grant number:2009BAI77B03]the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support[grant number:20172029]the Innovative Research Team of High-level Local Universities in Shanghai[grant number:ZDCX20211201].
文摘Background As the population in China rapidly ages,the prevalence of mild cognitive impairment(MCI)is increasing considerably.However,the causes of MCI vary.The continued lack of understanding of the various subtypes of MCI impedes the implementation of effective measures to reduce the risk of advancing to more severe cognitive diseases.Aims To estimate the prevalence and incidence rates of two MCI subtypes—amnestic MCI(aMCI)and vascular cognitive impairment without dementia(VCIND)—and to determine modifiable factors for them among older individuals in a multiregional Chinese cohort.Method This 1-year longitudinal study surveyed a random sample of participants aged≥60 years from a large,community-dwelling cohort in China.Baseline lifestyle data were self-reported,while vascular and comorbid conditions were obtained from medical records and physical examinations.In total,3514 and 2051 individuals completed the baseline and 1-year follow-up assessments,respectively.Logistic and linear regression analyses were used to identify the modifiable factors for MCI subtypes and predictors of cognitive decline,respectively.Results Among our participants,aMCI and VCIND demonstrated prevalence of 14.83%and 2.71%,respectively,and annual incidence(per 1000 person-years)of 69.6 and 10.6,respectively.The risk factor for aMCI was age,whereas its protective factors were high education level,tea consumption and physical activity.Moreover,VCIND risk factors were age,hypertension and depression.The presence of endocrine disease,cerebral trauma or hypertension was associated with a faster decline in cognition over 1 year.Conclusions MCI is a serious health problem in China that will only worsen as the population ages if no widespread interventions are implemented.Preventive strategies that promote brain activity and support healthy lifestyle choices are required.We identified modifiable factors for MCI in older individuals.The easy-to-adopt solutions such as tea consumption and physical activity can aid in preventing MCI.
基金supported by a grant from University of Social Welfare and Rehabilitation Sciences for the research expenses.
文摘Background Schizophrenia is characterised by pervasive cognitive deficits that significantly impair daily functioning and quality of life.Pharmacological treatments have limited efficacy in addressing these deficits,highlighting the need for adjunctive interventions like computerised cognitive training(CCT).Aims This study aimed to evaluate the effects of a 30-session CCT programme on mental well-being and cognitive performance in individuals with schizophrenia.Additionally,it assessed the usability and acceptability of CCT in this population.Methods A double-blind,randomised clinical trial was conducted with 54 participants assigned to intervention and control groups.Cognitive and mental health outcomes were assessed using validated tools such as the Depression Anxiety Stress Scale 21,the Warwick-Edinburgh Mental Wellbeing Scale and the Cambridge Neuropsychological Test Automated Battery.Usability was measured with the System Usability Scale(SUS).Assessments were conducted at baseline,post-intervention and 3 months post-follow-up.Results The CCT intervention significantly improved mental well-being,reduced stress and enhanced working memory(paired associate learning,spatial working memory and spatial span)compared with controls.However,no significant effects were observed for anxiety,depression or executive function.Usability scores were high(SUS=83.51),and compliance rates were strong(92.7%),indicating favourable participant engagement.Conclusion CCT demonstrated potential as an adjunctive treatment for schizophrenia,with significant improvements in targeted cognitive and mental health domains.The high usability and compliance rates support its feasibility for broader implementation.Further research is needed to optimise protocols and explore long-term benefits.CCT offers a promising approach to addressing mental health and cognitive challenges in schizophrenia,particularly for stress and working memory.Its usability and acceptability suggest it could be seamlessly integrated into clinical practice.
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.
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.
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.
文摘According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.
文摘Cognitive bias,stemming from electronic measurement error and variability in human perception,exists in cognitive electronic warfare and affects the outcomes of conflicts.In this paper,the dynamic game approach is employed to develop a model for cognitive bias induced by incomplete information and measurement errors in cognitive radar countermeasures.The payoffs for both parties are calculated using the radar's anti-jamming strategy matrix A and the jammer's jamming strategy matrix B.With perfect Bayesian equilibrium,a dynamic radar countermeasure model is established,and the impact of cognitive bias is analyzed.Drawing inspiration from the cognitive bias analysis method used in stock market trading,a cognitive bias model for cognitive radar countermeasures is introduced,and its correctness is mathematically proved.A gaming scenario involving the AN/SPY-1 radar and a smart jammer is set up to analyze the influence of cognitive bias on game outcomes.Simulation results validate the effectiveness of the proposed method.
文摘Muñoz Zamora et al.'s study^([1])is the first to investigate how cognitive processes can directly affect thermoregulation.By combining behavioral conditioning,engram labeling,and neural manipulation techniques,the authors demonstrate that mice are capable of can form and retrieve memories of cold environments.Remarkably,recalling these memories induces metabolic responses typically associated with actual cold exposure.This work represents a significant advancement in our understanding of brain,body interactions,particularly in how learned experiences can modulate fundamental homeostatic processes.The findings have broad implications across multiple fields of neuroscience and physiology.
文摘The concept of the brain cognitive reserve is derived from the well-acknowledged notion that the degree of brain damage does not always match the severity of clinical symptoms and neurological/cognitive outcomes.It has been suggested that the size of the brain(brain reserve) and the extent of neural connections acquired through life(neural reserve) set a threshold beyond which noticeable impairments occur.In contrast,cognitive reserve refers to the brain's ability to adapt and reo rganize stru cturally and functionally to resist damage and maintain function,including neural reserve and brain maintenance,resilience,and compensation(Verkhratsky and Zorec,2024).
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 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Supported by the Pharmaceutical Science and Technology Project of Zhejiang Province,No.2023RC266the Natural Science Foundation of Ningbo,No.202003N4266.
文摘BACKGROUND Group cognitive behavioral therapy(GCBT)is increasingly being used to treat obsessive-compulsive disorder(OCD)because of its high efficiency,economy,and interaction among group members.However,the changes in network functional connectivity(FC)in patients with OCD with GCBT remain unclear.AIM To investigate inter-and intra-network resting-state FC(rs-FC)abnormalities before and after GCBT in unmedicated patients with OCD and validate the efficacy of GCBT.METHODS Overall,33 individuals with OCD and 26 healthy controls underwent resting-state functional magnetic resonance imaging.The patients were rescanned 12 weeks after GCBT.Four cognition-related networks-default mode network(DMN),dorsal attention network(DAN),salience network(SAN),and frontoparietal network(FPN)-were selected to examine FC abnormalities within and between OCD networks before and after GCBT.Neuropsychological assessments including memory,executive function,speech,attention,and visuospatial ability were reassessed following GCBT.Pearson’s correlations were used to analyze the relationship between aberrant FC in cognition-related networks and altered neuropsychological assessments in patients.RESULTS Rs-FC within the DMN and DAN decreased significantly.Additionally,rs-FC between the DMN-DAN,DMNFPN,DMN-SAN,and DAN-SAN also decreased.Significant improvements were observed in cognitive functions,such as memory,executive function,attention,and visuospatial ability.Furthermore,reduced rs-FC within the DMN correlated with visuospatial ability and executive function;DAN positively correlated with Shape Trails Test(STT)-A test elapsed time;DMN-DAN negatively correlated with Rey-Osterrieth Complex Figure(Rey-O)mimicry time and the three elapsed times of the tower of Hanoi;DMN-SAN negatively correlated with Rey-O imitation time and positively correlated with STT-A test elapsed time;and DMN-FPN negatively correlated with Auditory Word Learning Test N1 and N4 scores.CONCLUSION Decreased rs-FC within the DMN and DAN,which correlated with executive function post-treatment,has potential as a neuroimaging marker to predict treatment response to GCBT in patients with OCD.
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Supported by Science and Technology Development Fund of Shanghai Pudong New Area,No.PKJ2023-Y20Key Discipline Construction Fund of the Shanghai Pudong New Area Municipal Commission of Health and Family Planning,No.PWZxk2022-18Pudong New Area Construction Project of National Traditional Chinese Medicine Development Comprehensive Reform Pilot Zone,No.PDZY-2022-0501.
文摘BACKGROUND Major depressive disorder(MDD)and bipolar depression(BD-D)are both intricate,enduring,and profound psychiatric conditions characterized primarily by depressive episodes and cognitive dysfunction.However,distinguishing the characteristics and influencing factors of cognitive impairment in unipolar and BD-D is crucial for identification and intervention.AIM To compare neurocognitive characteristics and investigate associations between cognitive function and clinical features in unipolar and BD-D.METHODS The THINC-integrated tool(THINC-it)as a cognitive assessment tool was applied to 295 individuals:75 patients with depressive disorders(MDD),120 individuals with BD-D,and 100 healthy controls.The Hamilton Depression Scale-17(HAMD),Hamilton Anxiety Scale-14(HAMA),and Pittsburgh Sleep Quality Index(PSQI)were employed to assess depression,anxiety,and sleep.Neurocognitive function characteristics and the relationships between cognitive impairment and general clinical attributes were analyzed.RESULTS There were no statistically significant differences in the overall THINC-it with each objective subscale.However,the subjective subscale(Perceived Deficits Questionnaire for Depression-5-item)showed significant differences between MDD and BD-D(P<0.001).Linear regression analyses were explored to determine associations.Age,years of education,age at onset,and HAMD were significantly co-associated with the overall THINC-it and each subscale in both MDD and BD-D(P<0.05).Furthermore,years of education showed a positive correlation with objective cognitive impairment(e.g.,Codebreaker,Trails)(P<0.05).There was a notable difference in that the number of depressive episodes,disease duration,hospitalizations,HAMA,and PSQI were significantly associated with the overall THINC-it with each subscale between MDD and BD-D(P<0.05).CONCLUSION Although both unipolar and BD-D showed similar objective cognitive impairments,there was a significant difference in subjective cognitive impairment.Our findings suggest that factors like age,years of education,age at onset,and depression severity might not be significantly difference in the influence of cognitive impairment.Furthermore,we found that education was a protective factor for cognitive impairment in both unipolar and BD-D.Our analysis revealed that distinct factors including disease duration,number of depressive episodes,hospitalizations,anxiety levels,and sleep quality influenced cognitive impairment between unipolar and BD-D.Therefore,it was important to investigate the specific characteristics of cognitive impairment and influencing factors to identify differentiating unipolar and BD-D.
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.
基金Supported by The Korea Health Technology Project through the Korea Health Industry Development Institute,funded by the Ministry of Health and Welfare,Republic of Korea,No.RS-2023-KH138802.
文摘BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal medicine for cognitive impairment;yet,clinical research on acupotomy is lacking.Although most TKM treatments occur in primary care,the research is largely hospital-based.This registry was established to systematically collect real-world data on the clinical progress,efficacy,and safety of TKM with acupotomy for patients with MCI or SCD in primary care.It is hypothesized that TKM with acupotomy improves cognitive function and is safe for these patients.AIM To establish an MCI or SCD registry of patients receiving TKM,including acupotomy,to analyze its clinical efficacy and safety.METHODS This observational registry study will be conducted across 22 medical institutions;approximately 500 participants will be recruited.Data—sociodemographic information,medication history,height,weight,vital signs,and assessment questionnaires(Montreal Cognitive Assessment-Korean,short form of Korean-Everyday Cognition,Numeric Rating Scale,Korean version of the Insomnia Severity Index)—will be collected at 3-month intervals over a year.This study will also document the TKM treatment administered and any adverse events.Routine TKM procedures will be followed,with acupuncture and acupotomy administered as per protocol;treatments including herbal medicine,Chuna therapy,and moxibustion may be administered at the practitioner’s discretion.RESULTS The registry will capture a wide range of real-world clinical data regarding demographic profiles,treatment processes,and adverse events.This detailed documentation is expected to clarify patient characteristics,evaluate the clinical course,and identify factors that may affect cognitive improvement in patients with MCI and SCD.CONCLUSION This research may provide evidence supporting acupotomy for cognitive impairment in primary care by confirming its efficacy and safety,providing preliminary evidence for TKM-based interventions aimed at improving cognitive function.
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 Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in patients with MCI.METHODS This retrospective analysis involved 180 patients with MCI who were admitted to The First Hospital of Shanxi Medical University from January 2021 to June 2023.Participants were allocated into the research(n=98,receiving rTMS)and control groups(n=82,receiving sham stimulation).Memory tests,cognitive function assessments,event-related potential–P300 tests,and electroencephalogram(EEG)examinations were conducted pre-treatment and post-treatment.Further,memory quotient(MQ),cognitive function scores,and EEG grading results were compared,along with adverse reaction incidences.RESULTS Pre-treatment MQ scores,long-term and short-term memory,as well as immediate memory scores,demonstrated no notable differences between the groups.Post-treatment,the research group exhibited significant increases in MQ scores,long-term memory,and short-term memory compared to baseline(P<0.05),with these improvements being statistically superior to those in the control group.However,immediate memory scores exhibited no significant change(P>0.05).Further,the research group demonstrated statistically better post-treatment scores on the Revised Wechsler Memory Scale than the control group.Furthermore,post-treatment P300 latency and amplitude improved significantly in the research group,surpassing the control group.EEG grading in the research group improved,and the incidence of adverse reactions was significantly lower than in the control group.CONCLUSION Patients with MCI receiving rTMS therapy demonstrated improved memory and cognitive functions and EEG grading and exhibited high safety with fewer adverse reactions.
基金Ethics Committee of Taihe Hospital in Shiyan City(Project No.:2023XM008)。
文摘Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.
基金Supported by the Heilongjiang Provincial Health Commission Scientific Research Project,No.20230404040027the Scientific Technology Project of Qiqihar City,No.CSFGG-2025030.
文摘Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.
