Corrigendum to "Effects of mindfulness-based interventions on cognitive impairment in patients with cancer: A systematic review and meta-analysis" [Int J Clin Health Psychol. 2025 Apr-Jun;25(2):100576

Effects of mindfulness-based interventions on cognitive impairment in patients with cancer: A systematic review and meta-analysis

Background & Objective: The objective of this study was to explore the risk factors for cognitive impairment in patients with cerebral small vessel disease (CSVD), and to construct a predictive model for cognitive impairment in CSVD patients, providing personalized diagnostic and treatment strategies for patients. Methods: Clinical data and blood indicators of CSVD patients admitted to the Department of Neurology at the Second Affiliated Hospital of Shandong First Medical University from February 2022 to February 2023 were collected. Additionally, these patients underwent cranial MRI examinations and completed neurological and psychological assessments, including the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Based on the MoCA and MMSE results, the patients were divided into the cognitive impairment group and the normal cognitive group. Clinical data, blood indicators, and white matter lesion (WML) grades were compared between the two groups. Univariate logistic regression analysis was performed to identify the risk factors for cognitive impairment in CSVD patients. Using MoCA assessment results as the gold standard and several clinical indicators as independent variables, a logistic regression model was constructed. Predicted values were calculated based on this model, and a receiver operating characteristic (ROC) curve for the comprehensive diagnosis of multiple variables was plotted to evaluate the model’s accuracy. Results: A total of 134 CSVD patients were included, and cognitive impairment occurred in 98 cases, with an incidence rate of 73.13%, while 36 patients did not have cognitive impairment. Univariate logistic regression analysis of the collected variables identified eight factors: age, education level, hypertension, diabetes, cerebral hemorrhage, low-density lipoprotein cholesterol (LDL-C), hyperhomocysteine (HHCY), and WML grading. Multivariate logistic regression analysis identified age, LDL-C, and WML grading as the final predictive factors, establishing a combined diagnostic model to predict the probability of cognitive impairment in patients. The constructed ROC curve for the comprehensive diagnosis of multiple variables yielded an area under the curve of 0.870, indicating good accuracy. To facilitate clinical diagnosis, the combined diagnostic model was simplified into an L score calculation formula, with the optimal cutoff value of 5.223. When the L score is <5.223, the patient can be considered not having cognitive impairment, while an L score >5.223 indicates cognitive impairment, allowing for the prediction of the risk of cognitive impairment in patients. Conclusion: Age, education level, hypertension, diabetes, cerebral hemorrhage, LDL-C, HHCY, and WML grading are related risk factors for cognitive impairment in CSVD patients. Age, LDL-C, and WML grading are independent risk factors for cognitive impairment in CSVD patients. The clinical predictive model for cognitive impairment in cerebral small vessel disease, constructed using the final predictive factors, showed good performance and clinical utility. It facilitates individualized risk assessment for cognitive impairment in CSVD patients and allows for targeted follow-up observation for high-risk individuals.

Objectives To investigate the risk factors for cognitive impairment in Chinese type 2 diabetes mellitus (T2DM) patients of advanced age and to identify effective biomarkers of mild cognitive impairment (MCI) in these patients. Methods Chinese T2DM patients (n = 120) aged 50–70 years were divided into groups with impaired (mild, moderate, and severe) and normal cognitive function based on Montreal Cognitive Assessment and Mini-Mental State Examination scores. Data regarding demographic characteristics, clinical features of diabetes, biochemical markers, and metabolomics were collected. Results Age, educational level, duration of diabetes, fasting blood glucose (FBG), HbA1c, total cholesterol (TC), triglyceride (TG), and 24-hour urine protein were significantly associated with cognitive impairment in T2DM patients of advanced age. The severity of fundus retinopathy and the incidence of macrovascular disease also differed significantly among the groups (P < 0.05). Metabolomics analysis suggested that increased levels of glutamate (Glu), phenylalanine (Phe), tyrosine (Tyr), proline (Pro), and homocysteine (Hcy) and a decreased level of glutamine (Gln) were significantly associated with cognitive impairment in the T2DM patients (P < 0.05). Receiver operating characteristic curve analysis demonstrated that Glu, Gln, Phe, and Pro levels were significant predictors of cognitive impairment in the T2DM patients. Conclusions Age, educational level, duration of diabetes, and the levels of FBG, HbA1c, TC, TG, and 24-hour urine protein were considered as independent risk factors for cognitive impairment in older T2DM patients. Macrovascular and microvascular diseases also were closely associated with cognitive impairment in these patients. Together, Glu and Gln levels may represent a good predictive biomarker for the early diagnosis of cognitive impairment in T2DM patients.

Objective: To explore the influencing factors of cognitive impairment in patients with silicosis, and to analyze the effect of brain-derived neurotrophic factor (BDNF) on cognitive function. Methods: In March 2021, 484 silicosis patients from April 2018 to April 2020 were included in the study. The Montreal Cognitive Assessment Scale of Chinese version was used to evaluate their cognitive function, and they were divided into the cognitive impairment group (n=282) and the non cognitive impairment group (n=202) , another 30 healthy persons from body check were served as control group. The concentrations of BDNF were compared between the three groups. And the receiver operating characteristic (ROC) curve was drawed to analyze the value of BDNF in predicting cognitive impairment in silicosis patients. And the logistic regression analysis was used to explore the risk factors of cognitive impairment. Results: The incidence of cognitive impairment in silicosis patients was 58.26% (282/484) . The level of BDNF in the cognitive impairment group[ (10.32±2.11) mg/L] was significantly lower than that in the non cognitive impairment group[ (13.43±3.45) mg/L] (t=-12.27, P<0.001) . The results of ROC curve analysis showed that the area unde the curve of BDNF in predicting cognitive impairment of silicosis patients was 0.763 (95%CI: 0.613-0.874, P=0.024) , the cut off value was 10 mg/L, the sensitivity was 0.88, and the specificity was 0.84. Logistic regression analysis showed that the level of BDNF (≤10 mg/L) , age (≥65 years old) , course of disease (≥5 years) and diabetes mellitus were the risk factors of cognitive impairment in silicosis patients (OR=2.346, 95%CI: 1.654-3.103; OR=1.757, 95%CI: 1.214-1.998; OR=1.346, 95%CI: 1.112-1.564; OR=1.165, 95%CI: 1.102-1.542, P=0.001, 0.012, 0.027, 0.036) . Conclusion: BDNF may be one of the indicator to predict the risk of cognitive impairment in patients with silicosis.

BackgroundAtrial fibrillation (AF) is a common cardiac arrhythmia associated with significant cardiovascular morbidity and mortality, as well as cognitive impairment (CI). The interplay between AF and CI is complex, involving various pathophysiological changes and numerous risk factors. Among them, depression has emerged as a significant contributor to both AF and CI, further complicating the relationship between these conditions. ObjectivesThis systematic review and meta-analysis aimed to investigate the influence of depression on the development of cognitive impairment in AF patients and assess the predictive value of the CHA2DS2-VASc score for CI risk. MethodsWe searched PubMed, Scopus, and Web of Science for relevant studies without language or date restrictions. Ten studies, comprising 1,605,577 participants, were included. A random-effects model was used for meta-analysis, and heterogeneity was assessed using I2 statistics. Funnel plots and Egger's test evaluated publication bias. ResultsDepression significantly increased the risk of CI in AF patients (OR: 2.23, 95 % CI: 1.54–3.21, p < 0.01; I2=99 %). This association persisted in studies excluding baseline CI (OR: 1.95, 95 % CI: 1.33–2.85, p < 0.01; I2=88 %). Subgroup analysis confirmed these results for both prospective (OR: 1.78, 95 % CI: 0.92–3.44, p = 0.02; I2=65 %) and retrospective studies (OR: 2.63, 95 % CI: 1.75–3.93, p < 0.01; I2=100 %). Analysis of CHA2DS2-VASc risk factors showed associations with CI, particularly cerebrovascular disease (OR: 1.86, 95 % CI: 1.61–2.16). ConclusionsOur findings support the association between depression and cognitive impairment in AF patients, demonstrating the importance of addressing mental health in cardiovascular care. Future research is necessary for a comprehensive understanding of this association.

Introduction Single-centre studies have shown a high prevalence of undiagnosed cognitive impairment in patients undergoing vascular surgery. The aim of this meta-analysis was to estimate the pooled prevalence of cognitive impairment in vascular surgery patients. Methods A systematic review and meta-analysis was performed of studies reporting cognitive impairment in vascular surgery patients (PROSPERO registration: CRD42019134684). Databases searched included: Medline, Embase, Emcare, CINAHL, PsychINFO and Scopus. Studies were excluded if they: did not use a validated cognitive assessment tool, included patients with asymptomatic or sub-threshold (for treatment) disease, or excluded patients with cognitive impairment. Quality of included studies was assessed using Newcastle-Ottawa scores (NOS), risk of bias was assessed using the ROBINS-E tool, and quality of evidence assessed using GRADE criteria. A pooled estimate of prevalence was calculated using the inverse-variance method separately for carotid artery disease (CAD), lower extremity arterial disease (LEAD), and studies including patients with multiple vascular surgery presentations. Data were pooled using random effects models and estimated prevalence presented with 95% confidence intervals (95%CI). Subgroup analyses were performed by cognitive assessment tool used. Authors of 24 studies meeting inclusion criteria that did not report numbers of cognitively impaired patients were contacted to enable inclusion: responses are awaited. Results After de-duplication of search results, 7,169 records were screened and 11 studies (911 patients) included in the meta-analysis. Nine studies were deemed high quality (NOS ≥7) however 8 studies had a serious risk of bias. Only one study explicitly stated provision for recruiting patients without capacity. Six different tools were used to assess cognitive function (MoCA, MMSE, ACE-R, HDS-R, Mini-Cog and a global cognitive score). Two studies found an association of cognitive impairment with post-op delirium whilst one did not, and a further study showed an association with increased length of stay. Pooled estimate of prevalence of cognitive impairment in CAD patients was 38% (95%CI 17%, 62%; 7 studies), and in “vascular surgery patients” was 61% (95%CI 47%, 74%, 3 studies). Only one study reported prevalence of cognitive impairment in LEAD patients alone of 19% (95%CI 14%, 24%). Quality of evidence was moderate to very low. Conclusions Cognitive impairment is highly prevalent in vascular surgery patients highlighting the need for close collaboration between vascular surgeons and geriatricians.

ObjectiveThe study investigated the correlation and predictive value between the severity of cerebral microbleeds (CMBs) and the level of serum High Mobility Group Protein B1 (HMGB1) and the occurrence of cognitive impairment in patients with cerebral small vessel disease (CSVD).MethodsA total of 139 patients with CSVD admitted to the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical University from December 2020 to December 2022 were selected as study subjects. The Montreal Cognitive Assessment (MoCA) scale was used to assess the cognitive function and was divided into the cognitive impairment group and the cognitive normal group. Magnetic Resonance Imaging (MRI) and Susceptibility Weighted Imaging (SWI) were used to screen and assess the severity of CMBs. Serum HMGB1 levels of CSVD patients were measured by enzyme linked immunosorbent assay (ELISA). Multivariable logistic regression analysis was used to explore risk factors for cognitive impairment and CMBs. Pearson correlation analysis was used to investigate the correlation between HMGB1 and cognitive function. Receiver Operating Characteristics (ROC) curves were used to assess the predictive value of HMGB1 for the occurrence of cognitive impairment in patients with CMBs.ResultsHigh Mobility Group Protein B1, uric acid (UA), glycosylated hemoglobin (HbA1c), CMBs, lacunar cerebral infarction (LI), years of education, and history of hypertension were risk factors for cognitive impairment (P < 0.05); HMGB1 was significantly and negatively associated with total MoCA score, visuospatial/executive ability, and delayed recall ability (P < 0.05). HMGB1 was significantly and positively correlated with the number of CMBs (P < 0.05). The area under the ROC curve for HMGB1 predicting cognitive impairment in patients with CMBs was 0.807 (P < 0.001).ConclusionSerum HMGB1 levels are associated with the development of cognitive impairment in CSVD patients, and serum HMGB1 levels have a high predictive value for the development of cognitive impairment in CSVD patients with combined CMBs, which can be used for early clinical identification and intervention of vascular cognitive impairment.

Background/Aim. It is necessary to find relevant oxidative stress markers for predicting the severity of obstructive sleep apnea-hypopnea syndrome (OSAHS), a sleep disorder-related respiratory disease. The aim of the study was to investigate if there is a correlation between oxidative stress and cognitive impairment in OSAHS patients. Methods. A total of 220 patients were divided into the group of snoring patients, the group with mild to moderate OSAHS, and the group with severe OSAHS according to polysomnography (PSG). Apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and baseline data were monitored. Oxidative stress indices were measured by colorimetry from blood samples taken early in the morning. The patients were then divided into the group with normal cognition and cognitive impairment group based on minimental state examination (MMSE) and Montreal cognitive assessment (MoCA). Independent risk factors for cognitive impairment were analyzed by multi-variate logistic regression. The correlation between oxidative stress and cognitive impairment was analyzed by Pearson?s method. Receiver operating characteristic (ROC) curves made it possible to analyze the efficiency of oxidative stress combined with detection for assessing cognitive impairment in OSAHS patients. Results. The snoring group, mild to moderate OSAHS group, and severe OSAHS group had significantly different snoring loudness, body mass index (BMI), AHI, ODI, MoCA, and MMSE scores, and levels of malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) (p &lt; 0.05). The cognitive impairment group and group with normal cognition had different BMI, GSH-Px, MDA, SOD, neuroglobin, hypoxia-inducible factor, AHI, and lowest nocturnal oxygen saturation (p &lt; 0.05 or p &lt; 0.01) levels. BMI, GSH-Px, MDA, SOD, neuroglobin, hypoxia-inducible factor, AHI, and lowest nocturnal oxygen saturation were independent risk factors for cognitive impairment. The MoCA and MMSE scores of cognitive impairment had positive correlations with GSH-Px and SOD but negative correlations with MDA (p &lt; 0.05). The area under the ROC curve of GSH-Px, MDA, and SOD and their combination for prediction of cognitive impairment were 0.670, 0.702, 0.705, and 0.836, respectively. Conclusion. Oxidative stress may be the biochemical basis of cognitive impairment in OSAHS patients.

Cognitive impairment is prevalent in Chinese patients with hypertension; however, current evidence on prevalence and risk factors is required to be synthesized. This systematic review and meta-analysis aimed to evaluate the prevalence and risk factors of cognitive impairment in Chinese patients with hypertension. Two reviewers independently searched PubMed, Web of Science, Embase, The Cochrane Library, CNKI, CBM, the Wanfang database, and the VIP database from their inception to 7 June 2023. The gray literature and the reference lists of the included studies were also retrieved manually. Moreover, we also independently performed the eligibility screening, data extraction, and data synthesis. The primary outcome was the prevalence of cognitive impairment in Chinese patients with hypertension, and the secondary outcomes were the risk factors for cognitive impairment in patients with hypertension. R (version 4.0.3) was used for data synthesis. In total, 82 studies involving 53,623 patients with hypertension were included in this meta-analysis. The pooled prevalence of cognitive impairment in patients with hypertension was 37.6% (95% CI: 33.2-42.2%). A total of 12 risk factors, including advanced age (r = -0.34, 95% CI: -0.45, -0.21), female sex (OR = 1.15, 95% CI: 1.01-1.32), BMI > 24 Kg/m2 (OR = 1.76, 95% CI: 1.04-3.00), lower educational level (OR = 2.01, 95% CI: 1.10-3.67), single status (OR = 1.63, 95% CI: 1.32-2.02), complications with diabetes (OR = 1.44, 95% CI: 1.14-1.80), coronary heart disease (OR = 1.49, 95% CI: 1.12-1.97), higher stage of hypertension [stage 3 vs. stage 1, OR = 3.08, 95% CI: 1.82-5.22; stage 2 vs. stage 1, OR = 1.83, 95% CI: 1.29-2.60], no regular physical activity (OR = 0.40, 95% CI: 0.21-0.77), higher levels of systolic blood pressure (r = -0.25, 95% CI: -0.42, -0.08), Hcy (r = -0.39, 95% CI: -0.63, -0.09), and IL-6 (r = -0.26, 95% CI: -0.48, -0.02) were detected. Cognitive impairment is prevalent in Chinese patients with hypertension, and the increased prevalence was associated with several demographic characteristics, complicated disease, no regular physical activity, worse hypertension status (higher stages and SBP), and high levels of biomarkers. Therefore, more attention should be paid to the early identification and treatment of patients with hypertension who are at high risk for cognitive impairment in clinical practice. In addition, relevant risk factors should be controlled to reduce the incidence of cognitive impairment. http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023410437].

Background and ObjectiveWhite matter hyperintensities (WMH) are magnetic resonance imaging manifestations of brain white matter lesions, which are common in the elderly. There is a correlation between WMH and cognitive impairment, but its imaging features lack heterogeneity, which makes early diagnosis difficult. Studies have found that cognitive impairment in patients with WMH is closely related to changes in the expression of serum inflammatory markers. This article reviews the correlation between WMH and cognitive function, as well as the correlation between cognitive impairment and serum inflammatory markers in patients with WMH.MethodsWe searched the China National Knowledge Infrastructure (CNKI), PubMed, Medline and EMBASE databases to identify studies on the correlation between cognitive impairment and serum inflammatory markers in patients with WMH published between the databases’ dates of inception and December 2021.Key Content and FindingsSerum inflammatory markers such as C-reactive protein (CRP), tumor necrosis factor α (TNF-α), plasma lipoprotein phospholipase A2 (Lp-PLA2) and interleukins (ILs) are closely related to cognitive impairment in patients with WMH.ConclusionsCRP, TNF-α, ILs and others systemic inflammatory markers can be used to help diagnose and predict cognitive impairment in WMH patients. But more in-depth and comprehensive research is needed to determine the role of systemic inflammatory markers in diagnosing WMH cognitive impairment.

Hypertension is a common chronic disease in the elderly population, and its association with cognitive impairment has been increasingly recognized. Cognitive impairment, including mild cognitive impairment and dementia, can significantly affect the quality of life and independence of elderly individuals. Therefore, identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes. Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients. Malnutrition or inadequate nutrition can lead to various health problems, including weakened immune system, increased susceptibility to infections, and impaired physical and mental function. Furthermore, poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations. In this observational study, we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment. By collecting baseline data on general information, body composition, and clinical indicators, we hope to identify risk factors for cognitive impairment in this patient population. The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension, particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment. To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status, analyze the internal relationship between nutritional statuses and cognitive impairment, and build a nomogram model for predicting nutritional status in elderly hypertensive patients. The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1, 2024 to September 30, 2024 as study subjects, and the 200 patients were divided into a modeling cohort (140 patients) and a validation cohort (60 patients) according to the ratio of 7:3. The modeling cohort were divided into a malnutrition group (26 cases), a malnutrition risk group (42 cases), and a normal nutritional status group (72 cases) according to the patients' Mini-Nutritional Assessment Scale (MNA) scores, and the modeling cohort was divided into a hypertension combined with cognitive impairment group (34 cases) and a hypertension cognitively normal group (106 cases) according to the Montreal Cognitive Assessment Scale (MoCA) scores, and the validation cohort was divided into a hypertension combined with cognitive impairment group (14 cases) and hypertension cognitively normal group (46 cases). The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients. Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment, the roadmap prediction model was established and validated, the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model, the calibration curve was used to assess the consistency between the predicted events and the actual events, and the decision curve analysis was used to evaluate the validity of the model. Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores. In this research, the modeling cohort comprised 140 cases, while the verification cohort consisted of 60 cases, with no notable discrepancy in the data between the two groups. In the modeling cohort, there were significant differences in body mass index (BMI), albumin (ALB), hemoglobin (Hb) and homocysteine levels among the malnourished group, the malnourished risk group and the normal nutritional status group. The results of univariate and multivariate analysis showed that BMI [odds ratio (OR) = 0.830, P = 0.014], ALB (OR = 0.860, P = 0.028), Hb (OR = 0.939, P = 0.035) and MNA score (OR = 0.640, P = 0.000) were independent protective factors for patients without cognitive impairment, and alkaline phosphatase (ALP) (OR = 1.074, P = 0.000) was an independent risk factor for patients with cognitive impairment. In this study, the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes. This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients. ALP was negatively correlated with MoCA score, while BMI, MNA score, Hb and ALB were positively correlated with MoCA score. BMI, MNA score, Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score. ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score. The column line graph model established in the study has a good predictive value.

Objectives Chronic Obstructive Pulmonary Disease (COPD) remains a serious public health problem globally, and the mortality rate for older COPD patients with cognitive impairment is almost three times that of older patients with cognitive impairment or COPD. The aim of this study was to construct a nomogram prediction model for the risk of comorbid cognitive impairment in COPD patients and to evaluate its clinical application. It helps to detect cognitive impairment in COPD patients at an early stage and give them effective interventions in time, so as to delay the progression of COPD patients and improve their prognosis. Methods In this study, COPD patients hospitalised at the North China University of Science and Technology Affiliated Hospitalwere evaluated by the Montreal cognitive assessment (MoCA) scale for cognitive function, and divided into a case group and a control group on the basis of whether or not they were combined with cognitive impairment. Based on the basic characteristics of the patients and the laboratory indexes in the first 24 hours of hospitalisation, we conducted statistical analyses, screened out the risk factors and established the Nomogram Prediction Model by using the R software, and finally, we evaluated the clinical value of the model through the calculation of ROC curves for sensitivity, specificity and kappa value. Finally, the sensitivity, specificity and Kappa value were calculated by ROC curve to evaluate the clinical value of the model. Results After statistical analysis, C-reactive protein (CRP) and homocysteine (Hcy) were found to be the risk factors for combined cognitive impairment in COPD patients, and the Nomogram prediction model was constructed by combining CRP and Hcy and plotted the ROC curve, and it was found that its model finally screened the critical value of the total score of 62.55, and the area under the ROC curve of the model was 0.870, and the sensitivity was 84.7%, and the specificity was 80.4%, indicating that it has a high degree of consistency with the actual results. The area under the ROC curve of this model was 0.870, the sensitivity was 84.7%, the specificity was 80.4%, and the calculated Kappa value was 0.575, which indicated that the consistency between the prediction results and the actual results was better, and it had a higher clinical application value. Conclusions CRP and Hcy are closely associated with comorbid cognitive impairment in COPD patients, and increased levels of CRP and Hcy are associated with an increased risk of comorbid cognitive impairment in COPD patients. Combining both CRP and Hcy to create a nomogram model for predicting comorbid cognitive impairment in patients with COPD has good predictive ability.

Cognitive impairment (CI) is common among end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (MHD), yet its relationship with hemoglobin levels remains underexplored. This study aimed to investigate the association between hemoglobin levels and CI in MHD patients, as well as to identify other contributing factors. A cross-sectional study was conducted with 248 MHD patients (49.60% male, mean age 57.23 ± 13.16 years) from a single hemodialysis center. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) with CI defined as a score < 24. Hemoglobin levels were divided into quartiles (Q1: < 90g/L; Q2: 90-110g/L; Q3: 110-130g/L; Q4: >130g/L). Various independent variables, including age, sex, education level, dialysis duration, comorbidities, and laboratory parameters were analyzed using Spearman correlation test, and univariate and multivariate regression. Of the 248 patients, 33.90% (84 patients) had CI. Higher hemoglobin quartiles (Q3/Q4) were associated with better cognitive function (higher MMSE scores, P < 0.001) and improved performance across cognitive domains. The Spearman and logistic regression analyses revealed the potential associations between cognitive function (MMSE scores) and several factors, including age, education level, dialysis duration, comorbidities, pre-dialysis blood pressure, interdialytic hypotension, albumin, creatinine, uric acid, and hemoglobin (P < 0.05). Age (OR = 1.454, P < 0.001), male sex (OR = 0.171, P = 0.013), pre-dialysis diastolic blood pressure (OR = 0.884, P = 0.024), and uric acid (OR = 0.992, P = 0.007) were significantly linked with the presence of CI in MHD patients. Multivariate regression further confirmed that adequate hemoglobin concentration was an independent related factor against CI in MHD patients (Model 4, Q1 vs. Q3: OR = 15.395, 95% CI = 3.184-74.443, P < 0.001). Anemia is significantly associated with CI in MHD patients, and can still serve as a clinical marker for early detection and intervention in CI. Maintaining adequate hemoglobin levels may be linked with a reduced CI occurrence in hemodialysis patients. These findings highlight the importance of anemia management and tailored interventions to preserve cognitive function health in ESRD patients. Not applicable.

Orthostatic hypotension (OH) is a common symptom of multiple system atrophy (MSA), however, its role in cognitive impairment and the mechanism in these patients remains unclear. This study aims to assess the role of OH on cognitive impairment in MSA patients, as well as to explore the potential association of cerebral autoregulation (CA) and white matter hyperintensities (WMHs) on cognitive impairment. This observational study was conducted in three general hospitals in China from January 2018 to October 2023, with patients at one center followed up for 6months after enrollment. The primary outcomes included cognitive function assessed using the Mini-Mental State Examination (MMSE) and Montreal cognitive assessment (MoCA). Secondary outcomes included the results of the Head-up tilt test, scores for CA and the extent of WMHs. The 132 MSA patients included 72 men (54.54%) with a mean age of 61.16 (7.80) years. Among them, 80 patients (60.61%) had orthostatic hypotension, and 48 patients (36.36%) had cognitive impairment. OH plays an important role in cognitive impairment in MSA patients (OR = 0.328,95% CI 0.135-0.797, P = 0.014). Cognitive impairment was associated with impaired CA (OR = 0.088,95% CI 0.012-0.657, P = 0.018) and severe WMHs (OR = 0.030,95% CI 0.002-0.423, P = 0.009), particularly in the presence of OH. OH is associated with cognitive impairment in MSA patients, and cognitive decline is linked to impaired CA and increased WMHs. Future studies are needed to explore the mechanisms underlying cognitive impairment in MSA patients.

The aim of this systematic review is to present the pooled estimated prevalence and risk factors for cognitive impairment (CI) in patients with chronic obstructive pulmonary disease (COPD). Patients with COPD suffer from progressive and irreversible airflow limitation, resulting in continuous impairment of lung function, which in addition to causing lesions in the lungs, often accrues to other organs as well. In recent years, a growing number of cross-sectional and longitudinal studies have shown that hypoxia is an important factor in causing CI and that there is an important link between them, but the assessment of co-morbid neurocognitive impairment and dysfunction is often overlooked. Some studies suggest that the diagnosis of mild cognitive impairment (MCI) is considered a precursor to dementia symptoms, with an annual conversion rate of 5%-10%, and it has been suggested that MCI is a potentially reversible state that can be used as a window for intervention. There is a lack of evidence on the prevalence and influencing factors of CI and its MCI. A systematic review and meta-analysis. PubMed, Web of Science, the Cochrane Library, Ovid, Wiley, and Scopus were searched for cohort, case-control, and cross-sectional studies investigating the prevalence and risk factors of CI and MCI in COPD to June 2023 from building. Meta-analyses were performed to identify CI and MCI prevalence and risk factors using a random-effects model. The methodological quality assessment was conducted by the modified Newcastle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ). This study was registered on PROSPERO (CRD42021254124). In total, 41 studies (21 cohort studies, 7 case-control studies, and 13 cross-sectional studies) involving 138,030 participants were eligible for inclusion. Current evidence suggests that the average prevalence of CI and MCI in COPD was 20%-30% (95% CI, 0.17-0.28) and 24% (95% CI, 0.17-0.32), respectively. Significant heterogeneity existed both in CI and MCI (I2 = 99.76%, 91.40%, p<0.001). Mata-regression analysis showed that different region could be the source of heterogeneity in the pooled results. Cough, FEV1, PaO2, age, education, depression, and BODE index are influential factors in the development of CI in COPD. Integrated epidemiological evidence supports the hypothesis that the prevalence of CI in the COPD population has shown an increasing trend, with differences by region and by instrument. Cough, FEV1, PaO2, age, education, depression, and BODE index are influential factors in the development of cognitive impairment in COPD patients. We should promote early screening and management of COPD patients and take targeted measures to prevent and reduce the incidence of CI. This systematic evaluation and meta-analysis identifies seven important risk factors for the development of CI among COPD patients and exposes their current epidemiological findings to provide a theoretical basis for public health administrators and healthcare professionals to effectively increase the screening rate of cognitive impairment in patients with COPD as well as to carry out early intervention. PROSPERO).crd. york.ac.uk.