Activities Of Daily Living Scale Research Articles

Prestroke Cognitive Impairment: Frequency and Association With Premorbid Neuropsychiatric, Functional, and Neuroimaging Features.

Some patients with stroke have prestroke cognitive impairment (pre-SCI), but its etiology is not clear. The aim of this cross-sectional study was to assess the frequency of pre-SCI and its association with premorbid neuropsychiatric, functional, and neuroimaging features. Patients hospitalized in stroke unit with an informant who could complete IQCODE (Informant Questionnaire for Cognitive Decline in the Elderly) were included. Pre-SCI was diagnosed if the IQCODE score was >3.3. Prestroke assessment also included NPI-Q (Neuropsychiatric Inventory Questionnaire), the basic Activities of Daily Living and Instrumental Activities of Daily Living scales, and the Clinical Dementia Rating scale. A multivariate logistic regression model was used to evaluate the association of pre-SCI with age, sex, education, arterial hypertension, atrial fibrillation, white matter lesions, cerebral microbleeds, and pathological medial temporal lobe atrophy. IQCODE was available in 474 of 520 patients (91.2%; 45% women; mean age 75.5±13.3 years). Pre-SCI had a prevalence of 32.5% and was associated with prestroke NPI-Q (pre-SCI absent versus present, 1.7±2.3 versus 5.5±4.9; P<0.001), Activities of Daily Living scale (0.3±0.8 versus 1.8±1.9; P<0.001), Instrumental Activities of Daily Living scale (0.6±1.3 versus 3.8±4.0; P<0.001), and Clinical Dementia Rating scale score (0.7±1.7 versus 7.2±6.2; P<0.001). In the 271 patients with a magnetic resonance imaging available, the multivariate logistic regression showed that age (odds ratio [OR], 1.05 [95% CI, 1.62-9.73]), white matter lesions (OR, 1.26 [95% CI, 1.003-1.58]), and a pathological medial temporal lobe atrophy score (OR, 3.97 [95% CI, 1.62-9.73]) were independently associated with pre-SCI. In the 218 patients with ischemic stroke, white matter lesions (OR, 1.34 [95% CI, 1.04-1.72]) and medial temporal lobe atrophy (OR, 3.56 [95% CI, 1.38-9.19]), but not age, were associated with pre-SCI. One-third of patients admitted to a stroke unit have pre-SCI that is associated with preexisting neuropsychiatric symptoms and functional performance. White matter lesions and medial temporal lobe atrophy are associated with pre-SCI, suggesting that both small vessel disease and neurodegeneration might be involved in its etiology.

Clinical observation on treatment of Alzheimer's disease with Sun's scalp-abdominal acupuncture combined with donepezil hydrochloride.

To observe the effect of scalp-abdominal acupuncture combined with donepezil hydrochloride on cognition and life ability of patients with Alzheimer's disease (AD), so as to evaluate its clinical efficacy. Sixty AD patients were collected and randomly divided into control group (30 cases) and observation group (30 cases). Patients in the control group were treated with oral donepezil hydrochloride (5 mg, once daily). Patients in the observation group were treated with scalp-abdominal acupuncture at Baihui (GV20), Yintang (GV24+), Sishencong (EX-HN1), "emotional area", Shenting (GV24), "abdominal area 1""abdominal area 8", and bilateral Fengchi (GB20), Taixi (KI3), Xuanzhong (GB39), Zusanli (ST36) on the basis of control group, and electroacupuncture (10 Hz/50 Hz, 0.5 to 5.0 mA) was applied to EX-HN1, "emotional area""abdominal area 1" and "abdominal area 8", once daily, 30 min each time. Four weeks as a course of treatment, both the two groups were treated for two consecutive courses. Before and after treatment, the mini-mental state examination (MMSE), AD assessmennt scale-cognitive subscale (ADAS-Cog) and activity of daily living scale (ADL) were evaluated. The clinical efficacy index was calculated and safety was evaluated. After treatment, the MMSE and ADL scores were higher (P<0.05) and the ADAS-Cog score was lower (P<0.05) than those before treatment in both groups. Compared with the control group, the MMSE and ADL scores were increased (P<0.05) and ADAS-Cog score was decreased (P<0.05) in the observation group. The total effective rate of the observation group (26/30, 86.67%) was higher (P<0.05) than that of the control group (23/30, 76.67%). No adverse reactions occurred in both groups during the treatment. Scalp-abdominal acupuncture combined with donepezil hydrochloride can effectively improve the cognitive ability and daily living ability of AD patients, and the efficacy is better than that of oral donepezil hydrochloride alone.

The safety and efficacy of escitalopram and sertraline in post-stroke depression: a randomized controlled trial

ObjectivesThis study aims to evaluate the safety and efficacy of escitalopram and sertraline in post-stroke depression (PSD) patients, to provide more reliable therapeutics for cardiovascular and psychiatric clinical practice.MethodsWe recruited 60 patients (aged 40–89 years old) with an ICD-10 diagnosis of PSD, who were then randomly assigned to two groups and treated with flexible doses of escitalopram (10 to 20 mg/day, n = 30) or sertraline (50 to 200 mg/day, n = 30) for consecutive 8 weeks, respectively. The 24-item Hamilton Depression Rating Scale (HAMD-24), the 14-item Hamilton Anxiety Rating Scale (HAMA-14), the Treatment Emergent Symptom Scale (TESS), the Montreal Cognitive Assessment Scale (MOCA), and the Activity of Daily Living scale (ADL) were used to assess patients before, during, and after treatment for depression, anxiety, adverse effects, cognitive function, and daily living activities. Repeated measures ANOVA, the Mann–Whitney U test, the chi-square test (χ2), or Fisher’s exact test was employed to assess baseline demographics, response rate, adverse effects rate, and changes in other clinical variables.ResultsSignificant reduction in HAMD-24 and HAMA-14 scores was evaluated at baseline, as well as 1, 3, 4, 6, and 8 weeks of drug intervention (p < 0.01). There was a significant group difference in post-treatment HAMD-24 scores (p < 0.05), but no difference was observed in HAMA-14 scores (p > 0.05). Further analysis showed a significant variance in the HAMD-24 scores between the two groups at the end of the first week (p < 0.01). The incidence of adverse effects in both patient groups was mild, but there was a statistically significant difference between the two groups (p < 0.05). The improvement in cognitive function and the recovery of daily living abilities were comparable between both groups (p > 0.05).ConclusionEscitalopram and sertraline showed comparable efficacy for anxiety symptoms, cognitive function, and daily living abilities in PSD patients. In addition, escitalopram was more appropriate for alleviating depressive symptoms. To validate the conclusion, trials with a larger sample size are in demand in the future. The registration number is ChiCTR1800017373.

Functional dependence as a contributing factor for patient hand contamination by multi-drug resistant organisms (MDROs) in acute care.

Patient hands' contribution to disease transmission in healthcare settings is an important, understudied topic. We assessed correlation between patient functional dependence and hand contamination with multi-drug resistant organisms (MDROs) in acute-care settings. Secondary, cross-sectional analyses of 399 general medicine patients enrolled in two tertiary-care hospitals over a six-month period. Our predictor was patient functional status evaluated using Katz Activities of Daily Living scale, scored as follows: functionally independent (scored 0), moderately dependent (score 1-3), and severely dependent (score of 4 or more). Our outcome was patient hand contamination with MDROs, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, and resistant gram-negative bacteria. Of 399 patients, 298 were functionally independent, 45 were moderately dependent, and 56 were severely dependent. Odds of MDRO hand contamination were 2.63 (95% CI, 1.21-5.72) times higher in the severely dependent category compared to the independent category. Patients with feeding dependence had the highest odds of hand contamination with MDROs (OR 4.76, 95% CI, 1.54-14.71), followed by continence, dressing, and toileting. In addition to patient colonization, environmental contamination with MRSA was associated with patient function, with odds 2.60 (95% CI, 1.16-5.82) times higher in severely dependent patients. Patients with severe functional dependence are more likely to harbor MDROs on their hands and less likely to be able to cleanse them independently. Functionally dependent patients have high room contamination with MDROs. Patient hand hygiene interventions in the hospital should target this high-risk group.

Latent Class Analysis of Sleep in Mild Cognitive Impairment Patients and its Influencing Factors.

Individuals with mild cognitive impairment (MCI) frequently experience sleep disorders, which may elevate the risk of developing Alzheimer's disease. Yet, sleep types in MCI patients and the factors influencing them have not been sufficiently investigated. The objective of this study was to explore potential sleep typing and its influencing factors in patients with MCI using latent class analysis. A cross-sectional survey was conducted in Jiangsu Province, China. Cognitive function in older adults was assessed using neuropsychological tests, including the Montreal Cognitive Assessment Scale-Beijing version (MoCA), the Mini-Mental State Examination (MMSE), the Activities of Daily Living Scale (ADL), and the Clinical Dementia Rating Scale (CDR). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Latent class analysis based on PSQI scores and multinomial logistic regression analyses were employed to explore the influencing factors of sleep typing. The study included a total of 611 patients with MCI. Latent class analysis identified three latent classes to categorize the sleep patterns of MCI patients: the good sleep type (56.6%), the insufficient sleep type (29.6%), and the difficulty falling asleep type (13.7%). Potential sleep typing is influenced by gender, chronic disease, physical exercise, social activity, brain exercise, smoking, frailty, subjective cognitive status, and global cognitive function. The findings of this study underscore the notable heterogeneity in the sleep patterns of patients with MCI. Future research may provide targeted prevention and interventions to address the characteristics and influencing factors of patients with different subtypes of sleep MCI.

High Risk Factors and Preventive Measures of Bipolar Disorder After Ischemic Stroke.

Bipolar disorder (BD) is a recurrent chronic disease. There are few Chinese studies to explore the BD after ischemic stroke. This study aimed to analyze the high risk factors of BD after ischemic stroke and investigate prevention strategies. 197 patients with ischemic stroke in our hospital from March 2020 to March 2022 were selected as research subjects. The demographic information, clinical data, and scores of Mood Disorder Questionnaire (MDQ) and Activity of Daily Living Scale (ADL) in patients were retrospectively analyzed to count the incidence of BD in patients. Binary logistic regression analysis was used to analyze the influencing factors for BD after ischemic stroke, and preventive measures were discussed based on study results. The incidence of BD in patients with ischemic stroke was 45.18% (89/197), and the median and quartile in the first part of MDQ score was 6.00 (5.00,10.00) points. The subjects were divided into BD group (n = 89) and non-BD group (n = 108) based on the presence of BD in patients with ischemic stroke. Education background (OR = 0.485), lesions involving the frontal or temporal lobes (OR = 2.724), sleep disorders (OR = 2.246), and daily living ability (OR = 3.108) were influencing factors for BD after ischemic stroke (P < .05). The risk of BD after ischemic stroke is high. Based on the above research results, clinical attention should be paid to knowledge popularization, lesion examination, and the improvement of sleep quality and daily living ability, to prevent the occurrence of BD and improve the prognosis.

Assessment of frailty, daily life activities, and nutrition of elderly immigrants: A household based cross-sectional study.

With the global migrant population on the rise, it's imperative to focus on the health status of more vulnerable groups within these communities. The elderly immigrants face myriad physical and psychosocial challenges that significantly impact their health and quality of life. This study aims to investigate the nutrition, daily life activities, and clinical frailty status of elderly immigrants residing in Türkiye. A cross-sectional design was employed in the Sultanbeyli District, focusing on Syrian immigrants aged 65 and over. Participants were surveyed face-to-face by interpreters proficient in Arabic. The questionnaire comprised sociodemographic details, health status, and scales like Katz Daily Life Activities, Clinical Frailty, and Mini Nutritional Assessment. The data analysis was executed using SPSS 22. Continuous variables were presented as mean ± standard deviation (SD) and median, while categorical ones were expressed in numbers and percentages (%). A significance level of P < .05 was considered for the analyses. The average age of the participants was determined as 71.64 ± 6.20 years. In the study group, 49.7% were female, 75.5% were younger than 75 years old, 47.7% had less than primary school education, 56.3% were married, 42.4% had a low income level, and 56.9% lived in the same household with 5 or more people. Among the participants in the study group, 47% had walking and balance problems, 29.1% had a history of falls in the last year, 10.6% were disabled, 69.5% complained of pain, 82.8% had a chronic illness, and 43% had polypharmacy. The median value of the KATZ Daily Living Activities scale was 6, the mean score of the Clinical Frailty Score scale was 3.25 ± 1.25, and the mean score of the Mini Nutritional Assessment scale was 12.40 ± 2.15. Among immigrant elderly individuals, 88.1% were able to sustain their lives independently, 13.9% were clinically frail, and 3.3% were at risk of malnutrition. Factors such as age, level of education, socioeconomic status, marital status, number of cohabitants in the household, BMI, neurological problems, walking-balance disorders, disability, and presence of chronic diseases are associated with daily life activities, frailty, and malnutrition status. It is believed that broader field research with greater participation would be beneficial for evaluating the nutritional status of immigrant elderly individuals.

The Effects of Traditional Chinese Herbal Dietary Formula on the Ability of Daily Life and Physical Function in Elderly Patients with Mild Cognitive Impairment.

We aimed to examine the association of traditional Chinese herbal dietary formulas with ability of daily life and physical function in elderly patients with mild cognitive impairment. The current study included 60 cases of elderly patients with mild cognitive impairment from Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Shanghai University of Traditional Chinese Medicine and Hongkou District, Shanghai. The participants were randomly divided into two groups: group A (herbal dietary formula group, consisting of Alpiniae Oxyphyllae Fructus, Nelumbinis plumula, Chinese Yam, Poria cocos, and Jineijin), 30 cases, and group B (vitamin E), 30 cases, treatment for 3 months. Cognitive function was measured using the Montreal Cognitive Assessment (MOCA) and Mini-Mental State Examination (MMSE); body function was measured using the Chinese Simplified Physical Performance Test (CMPPT), including stand static balance, sitting-up timing, squat timing, and six-meter walk timing. Daily life based on ability was measured by grip strength and the Activity of Daily Living Scale (ADL). The lower the scores of the above items, the poorer the disease degree, except for ADL: the lower the score, the higher the self-care ability. After 3 months of treatment, the two-handed grip strength of both the herbal dietary formula group and vitamin E group increased; the ADL, sitting-up timing, squatting timing, and six-meter walking timing decreased after medication, being statistically significantly different (p < 0.05). The two-handed grip strength of group A increased significantly, and the ADL, sitting-up timing, squatting timing, and six-meter walking timing decreased distinctly compared with the vitamin E group. There was a statistically significant difference (p < 0.05). The scores of MMSE, MOCA, total CMPPT, and standing static balance of the herbal dietary formula group increased after medication. The difference was statistically significant (p < 0.05). The vitamin E group's MMSE and MOCA scores, CMPPT total scores, and standing resting balance scores did not change significantly after medication (p > 0.05). In summary, a traditional Chinese herbal dietary formula can improve body and cognitive function in patients with MCI, and the curative effect is better than that of vitamin E. Traditional Chinese herbal dietary formulas can improve the daily life quality of MCI patients, which has clinical application value.

Effectiveness of ginkgo diterpene lactone meglumine on cognitive function in patients with acute ischemic stroke.

To explore the efficacy of ginkgo diterpene lactone (GDLM) on cognitive function in patients with acute ischemic stroke (AIS). A total of 126 patients with AIS in Shaanxi Provincial People's Hospital from July 2019 to December 2020 were collected and randomly divided into the control group and treatment group (n = 63). All patients received conventional treatment, on which 25 mg/day GDLM was administered in the treatment group. Coagulation and inflammation indexes, National Institutes of Health Stroke Scale (NIHSS) and activities of daily living scale (ADL) scores were measured before and 14 days after treatment. NIHSS and ADL scores were performed again after 3 months. Cognitive function was assessed by Montréal Cognitive Assessment (MoCA) score, Mini-Mental State Examination (MMSE) score, and potential P300. After 14 days of treatment, all biochemical indices were lower than before treatment (P < 0.05). The NIHSS and ADL scores of the treatment group were significantly better than those of the control group after treatment (P < 0.05). The MoCA and MMSE scores of the treatment group improved more significantly compared with the control group (P < 0.05). After treatment, the P300 indexes of both groups were significantly better than before treatment (P < 0.05). Conventional treatment of AIS combined with GDLM can effectively improve the cognitive function of patients, which is worthy of clinical recommendation.

Serum Apo Lipoprotein E, Apo Lipoprotein E Gene Polymorphisms, and Parkinson's Disease.

A central role for apolipoprotein E (APOE) has been suggested in modulating processes of neurodegeneration. To study the association between serum APOE levels, APOE gene polymorphisms, and Parkinson's disease (PD). Fifty-five patients with PD and 30 healthy subjects were enrolled. PD patients were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS), Modified Hoehn and Yahr scale, and Schwab-England Activities of Daily Living scale. Serum APOE level and genotyping for APOE polymorphisms were done for PD patients and controls using enzyme-linked immunosorbent assay and polymerase chain reaction, respectively. Mean serum APOE level was significantly higher in PD patients compared with healthy controls. APOE ε2/4 genotype was present in a significantly higher proportion of patients compared with controls. APOE ε4 allele was significantly associated with a higher score on the "mentation, behavior, and mood section" of UPDRS compared with ε2 allele. APOE ε2 allele was significantly associated with a shorter disease duration compared with ε3 and ε4 alleles. Mean serum APOE level was significantly higher in patients presenting predominantly by rigidity and bradykinesia compared with those presenting predominantly by tremors. Serum APOE level was positively correlated with mean scores of "mentation, behavior, and mood section" of UPDRS and disease duration. Serum APOE level was a significant predictor for the scores of "mentation, behavior, and mood section" of UPDRS. APOE ε2/4 genotype might be a susceptibility variant for PD. There may be a possible role for APOE in modulating the process of neurodegeneration in PD.

Study on the Efficacy of Shugan Jieyu Capsules Combined with Trazodone in Patients with PostStroke Depression and Insomnia

Objective: To analyze the effectiveness of applying ShuGan JieYu Capsules (SGJYC) combined with trazodone in patients with post-stroke depression (PSD) with insomnia. Methods: 60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group (trazodone) and a research group (SGJYC combined with trazodone) of 30 cases each. Statistics were analyzed using the Hamilton Depression Rating Scale (HAM-D), Pittsburgh Sleep Quality Index (PSQI), and Activities of Daily Living (ADL) scale before treatment and 4, 8, and 12 weeks after treatment. Results: Before treatment, The results of HAM-D, PSQI, and ADL scale studies in the two groups before treatment were not statistically significant (P &gt; 0.05); 4, 8, and 12 weeks after treatment, the results of HAM-D and PSQI studies in the research group were lower than that of the reference group, and the results of ADL scale studies were higher than that of the reference group. There was a significant difference between the groups (P &lt; 0.05). The total adverse reaction rate of the research group was lower than that of the reference group, and there was a significant difference between the groups (P &lt; 0.05). Conclusion: The combination of SGJYC and trazodone reduced depression in post-stroke patients, corrected insomnia, improved sleep quality, was safe, and had a low rate of adverse reactions.

Effectiveness of Different Neurocognitive Intervention Approaches on Functionality in Healthy Older Adults: A Systematic Review.

Subtle loss of functionality in healthy older adults is considered one of the most important predictors of cognitive decline. Neurocognitive interventions are increasingly being used, from a preventive maintenance approach to functional capacity. This study evaluates the effectiveness of different neurocognitive approaches on the functionality of healthy older adults. In this systematic review (CRD42023473944), an extensive search was conducted for articles published in the last 10 years (2013-2023) in the following databases: Medline, Scopus, and Web of Science. A total of 809 trials were identified, of which 18 were considered to be eligible for inclusion in the review. The data revealed heterogeneity in sample size, measures of functional assessment, neurocognitive interventions used, number of sessions, session duration, and time. Traditional cognitive stimulation is shown to have no significant functional benefit, while other less commonly used neurocognitive interventions, such as those based on everyday cognition, are associated with more significant benefits. Moreover, it is demonstrated that although the Instrumental Activities of Daily Living scale (IADL) is the most used test in similar studies, it is not sensitive enough to detect changes in functionality in healthy elderly individuals, with other tests such as the Timed Instrumental Activities of Daily Living (TIADL) being more advantageous. Therefore, a new guideline is proposed for its use in clinical practice and research, using homogeneous study protocols and neurocognitive interventions that allow for the transfer and generalization of results in daily life.

Undernutrition in obese older adults by fat percentage

ObjectiveThe prevalence of obesity by fat percentage has seen a steady increase in older adults in recent years, secondary to increases in fat mass in body composition, even in healthy aging. Malnutrition is a common geriatric syndrome with serious clinical outcomes. Increases in fat mass and waist circumference with healthy aging should not prevent the risk of malnutrition from being masked. Malnutrition is often ignored in obese older people due to low BMI cut-off values in many screening tests. The present study seeks to raise awareness of the need to assess the frequency of undernutrition and related factors in obese older adults.MethodsThe data of 2013 community-dwelling patients aged ≥ 60 years who applied to a university geriatrics outpatient clinic between April 2012 and November 2022 were analyzed retrospectively, of which 296 were found to be obese based on fat percentage and were included in the study. Demographic data and the presence of any geriatric syndromes were obtained retrospectively from the patient files, functional status was assessed using the KATZ Activities of Daily Living (ADL) Scale and the LAWTON-BRODY Instrumental Activities of Daily Living Scale (IADL); frailty was screened using FRAIL-scale; and the sample was assessed for malnutrition using the Mini Nutritional Assessment-Short Form (MNA-SF), with undernutrition defined as an MNA-SF score of ≤11.\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\le 11.$$\\end{document} The patients’ fat percentage and weight were measured using a bioimpedance analyzer. Fatty obesity was defined using the Zoico methodology (fat percentage ≥\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\ge$$\\end{document} 27.3% for males, ≥\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\ge$$\\end{document} 40.7% for females),\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$,$$\\end{document} handgrip strength (HGS) was measured using a hand dynamometer, and probable sarcopenia was defined as low HGS based on regional cut-off values (35 kg for males, 20 kg for females).ResultsThe mean age of the 296 fatty obese older adults (102 males/194 females) was 74.4 + 6.5 years, and the median fat was 42.2% (27.4–59.5). Undernutrition was detected in 19.6% of the patients based on MNA-SF screening. A univariate analysis revealed age, sex, educational status, daily physical activity status, depression, difficulty in swallowing, chewing difficulty, probable sarcopenia, number of chronic diseases, and IADL to be associated with undernutrition, while a multivariate logistic regression analysis revealed depression [OR = 3.662, 95% CI (1.448–9.013), p = 0.005] and daily physical activity status [OR:0.601, 95% CI (0.417–0.867), p = 0.006] to be independently associated with malnutrition in obese older adults based on fat percentage.Conclusion The present study clarifies the significance of undernutrition in obese older adults also in our country, and recommends undernutrition screening to be carried out, by fat percentage, on obese older adults, especially with depression and low daily physical activity.

Reliability and validity of the online application of London Chest Activity of Daily Living scale in assessing dyspnea-related functional impairment in individuals after hospitalization for COVID-19

Purpose To investigate the test-retest reliability and construct validity of the LCADL scale applied via online form in individuals after hospitalization for COVID-19. Methods Methodological study. After hospitalization for COVID-19 individuals completed the LCADL via online form at two separate times. They also answered the post-COVID-19 Functional Status Scale (PCFS), dyspnea, fatigue, and health perception scales, modified Medical Research Council (MRCm), Short Form Health Survey 36 (SF-36). Hospitalization data were collected from the individual’s medical record. Results 104 individuals participated in the study (57 men, 45.2 ± 11.9 years). The LCADL showed moderately to high test-retest reliability (ICC: 0.73–0.86; p < 0.001), there was no difference in scores between test and retest (p > 0.05), the mean difference between the applications was smaller than the standard error of measurement and the internal consistency was adequate (Cronbach’s α = 0.70–0.94). In addition, it demonstrated adequate construct validity, showing correlations with PCFS, dyspnea perception, fatigue and health scales, mMRC, SF-36, and length of stay in the Intensive Care Unit (p < 0.05). The LCADL as percentage of the total score presented a significant floor effect (25%). Conclusion The LCADL applied online was reliable and valid for assessing limitations due to dyspnea in ADL in individuals after hospitalization for COVID-19.

Comprehensive analysis of clinical and biological features in Parkinson's disease associated with the LRRK2 G2019S mutation: Data from the PPMI study.

The Parkinson's Progression Marker Initiative (PPMI) aims to identify biomarkers for Parkinson's disease (PD) risk, onset, and progression. This study focuses on the G2019S missense mutation in the LRRK2 gene, which is associated with hereditary and sporadic PD. Utilizing data from the PPMI database, we conducted an analysis of baseline clinical characteristics, as well as serum and cerebrospinal fluid levels in two groups: patients with PD with the G2019S mutation (PD + G2019S) and patients with PD without the mutation (PD-G2019S). Multiple linear regression and longitudinal analysis were performed, controlling for confounding factors. Compared to the PD-G2019S group, the PD + G2019S group showed more obvious initial motor dysfunction-higher baseline Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS) scores (false discovery rate [FDR]-adjusted p < 0.001), but progressed more slowly. Mechanism of Coordinated Access and activities of daily living (ADL) scores were lower at baseline (FDR-adjusted p < 0.001), whereas Scales for Outcomes of Parkinson's Disease (SCOPA)-Thermoregulatory (FDR-adjusted p = 0.015) scores were higher, emphasizing the increase of non-motor symptoms associated with LRRK2-G2019S mutation. During the follow-up period, the motor and non-motor symptoms changed dynamically with time, and there were longitudinal differences in the scores of MDS-UPDRS (FDR-adjusted PI = 0.013, PII = 0.008, PIV < 0.001), Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (FDR-adjusted p = 0.027), SCOPA-Thermoregulatory (FDR-adjusted p = 0.021), and ADL (FDR-adjusted p = 0.027) scale scores. PD associated with the LRRK2 G2019S mutation demonstrated more severe symptoms at baseline but slower progression. Motor complications and thermoregulatory disorders were more pronounced.

IMPACTS OF ACCULTURATION ON HEALTH OF US OLDER CHINESE IMMIGRANTS

Abstract Acculturation from Asian- to Western-oriented values and cultural practices is a key aspect of social experience for many Asian Americans. The growing body of literature on this topic shows mixed findings on health impacts of acculturation and is largely relied on cross-sectional studies, preventing to draw definitive conclusions on the health impact of acculturation. The study aimed to examine long-term effects of acculturation on mental, physical, and cognitive health in U.S. older Chinese immigrants. Data were drawn from 2,811 participants (aged from 60 to 104 years) from the Population Study of Chinese Elderly in Chicago study. Acculturation was measured using a 12-item Acculturation Scale assessing language use, ethnic social relations, and media use. Health outcomes included depression assessed using the Patient Health Questionnaire-9, activities of daily living (ADL) assessed using the adapted Katz ADL Scale, and global cognition indexed by a composite score of episodic memory, working memory, executive function, and mental status. Results from latent growth curve models showed that high levels of acculturation were not associated with depression at baseline but predicted a faster decline in depression during the 6-year follow-up. Similarly, acculturation was not related to ADL at baseline but predicted a slower decline over time. Contrarily, acculturation was associated with better global cognition at baseline but was not related to long-term changes in cognition. These results suggest the long-term benefits of acculturation on mental and physical health among U.S. older Chinese immigrants. The health advantages related to acculturation, however, seem not to generalize to cognitive function.

Neuropsychological, plasma marker, and functional connectivity changes in Alzheimer's disease patients infected with COVID-19.

Patients with COVID-19 may experience various neurological conditions, including cognitive impairment, encephalitis, and stroke. This is particularly significant in individuals who already have Alzheimer's disease (AD), as the cognitive impairments can be more pronounced in these cases. However, the extent and underlying mechanisms of cognitive impairments in COVID-19-infected AD patients have yet to be fully investigated through clinical and neurophysiological approaches. This study included a total of 77 AD patients. Cognitive functions were assessed using neuropsychiatric scales for all participants, and plasma biomarkers of amyloid protein and tau protein were measured in a subset of 25 participants. To investigate the changes in functional brain connectivity induced by COVID-19 infection, a cross-sectional neuroimaging design was conducted involving a subset of 37 AD patients, including a control group of 18 AD participants without COVID-19 infection and a COVID-19 group consisting of 19 AD participants. For the 77 AD patients between the stages of pre and post COVID-19 infection, there were significant differences in cognitive function and psychobehavioral symptoms on the Montreal Scale (MoCA), the neuropsychiatric inventory (NPI), the clinician's global impression of change (CIBIC-Plus), and the activity of daily living scale (ADL). The COVID-19 infection significantly decreased the plasma biomarker level of Aβ42 and increased the plasma p-tau181 level in AD patients. The COVID-19-infected AD patients show decreased local coherence (LCOR) in the anterior middle temporal gyrus and decreased global correlation (GCOR) in the precuneus and the medial prefrontal cortex. The findings suggest clinical, cognitive, and neural alterations following COVID-19 infection in AD patients and emphasize the need for close monitoring of symptoms in AD patients who have had COVID-19 and further exploration of the underlying mechanisms.

A Single-Centre, Retrospective Research Evaluation of the Effect of Extended Intervention Model Based on Case Management of Treatment Compliance and Cardiac Function on Patients with Chronic Heart Failure

Objective: To explore the effect of case management-based extended intervention model on treatment compliance and cardiac function in patients with chronic heart failure. Methods: This study retrospectively analysed the clinical data of 203 patients with chronic heart failure at Xingtai Third Hospital from January 2019 to January 2022. In accordance with different intervention programs, the patients were divided into a study group (SG, n = 102) and a reference group (RG, n = 101). The SG received the extended intervention model based on case management, and the RG adopted the conventional intervention model. Comparison was conducted on the treatment compliance, cardiac function, activity of daily living scale (ADL) scores and readmission rates in both groups. Results: After intervention, the SG showed higher treatment compliance (p &lt; 0.05), lower heart rate, higher left ventricular ejection fraction, ratio of transmitral peak rapid filling velocity to transmitral peak atrial filling velocity at mitral orifice and six-minute walk distance (p &lt; 0.001) and significantly lower ADL score and readmission rates than the RG (p &lt; 0.05). Conclusion: The extended intervention model based on case management positively influences the treatment compliance of patients with chronic heart failure and continuously improves patients' cardiac function, reduces the readmission rate, enhances daily living ability, comprehensively increases clinical efficacy and benefits patients for a long period.

Neuroimaging Results and A4 in the Context of the LEARN Study

AbstractBackgroundThe A4 Study was a 240‐week, double‐blind, placebo‐controlled Phase 3 secondary prevention trial in cognitively unimpaired adults (ages 65‐85) with elevated amyloid on PET testing solanezumab, a monoclonal antibody targeting soluble amyloid‐beta. The companion LEARN Study enrolled participants who were otherwise eligible for A4 but did not show elevated amyloid.MethodEntry criteria included CDR‐Global Scale (CDR‐GS) = 0, MMSE≥25, WMS Logical Memory = 6‐18, and elevated amyloid on florbetapir PET (for A4). The primary outcome measure was the Preclinical Alzheimer Cognitive Composite (PACC) with key secondary functional measures: Cognitive Function Index (CFI), Activities of Daily Living Scale (ADL), and CDR‐GS. A subset of participants underwent flortaucipir Tau PET.ResultFor A4, 1169 randomized: 578 to solanezumab and 591 to placebo. Treatment groups were well matched. Solanezumab did not slow cognitive decline on the PACC (mean change (95% CI): placebo ‐1.13 (‐1.45,‐0.81); solanezumab ‐1.43 (‐1.83,‐1.03); p = .260). Secondary clinical outcomes were consistent, numerically favoring placebo. Across both arms, 36.1% progressed to symptomatic AD, defined as CDR‐GS&gt; 0 at two consecutive visits or final visit. Higher baseline amyloid levels were strongly associated with faster cognitive decline and greater risk of progression to symptomatic AD across both groups (p&lt;.001). Amyloid continued to accumulate in both placebo (65.9 centiloid baseline, 19.3 increase) and solanezumab (66.2 centiloid baseline, 11.6 increase) groups. Tau PET showed similar increases in placebo and solanezumab groups in medial temporal lobe and neocortical composites, that were negatively correlated with PACC decline. No serious safety signals for solanezumab were identified, with only one case of ARIA‐E. ARIA‐H rates were similar across groups. LEARN participants (N = 538, 4.2 centiloid baseline on amyloid PET) did not demonstrate cognitive decline.ConclusionThe A4 Study demonstrated the feasibility of conducting a large‐scale trial in preclinical AD, with cognitive and functional measures sensitive to decline. Solanezumab did not slow cognitive decline or clinical progression. Baseline amyloid PET was among the strongest predictors of decline across both placebo and solanezumab. LEARN participants did not demonstrate decline. These results suggest that amyloid plaque removal may be necessary even at this very early stage of AD.

Impact of Single Compared to Dual Sensory Loss in People with Dementia on Care Partner Outcomes

AbstractBackgroundBoth hearing and vision loss impact significantly on outcomes in people with dementia as well as their care partners. The study aimed to compare the impact on care partner outcomes of hearing loss alone and dual sensory (both hearing and vision) loss in people with dementiaMethodsThe study sample includes data from the SENSE‐Cog Trial (www.sense‐cog.eu). Care partner psychological distress was ascertained using the 12‐item General Health Questionnaire and the Hospital Anxiety and Depression Scale. Caregiving intensity was assessed using the care partner items of the RUD Lite. Dementia symptoms were assessed with the MOCA, the 12‐item Neuropsychiatric Inventory and the Bristol Activities of Daily Living scale. Vision loss was defined by the presence of binocular visual acuity of not more than 6/9.5 and greater than 6/60 in Snellen metric using the Portable Eye Examination Kit (PEEK) vision tool and visual field greater than 10° using confrontation visual field test. Hearing loss was defined by a bilateral hearing difficulty, indicated by failure of a pure tone hearing screening test in both ears. Statistical analyses included comparison between groups with different sensory losses (hearing‐ vs. dual loss) and regression analyses.ResultsData of dyads of people with dementia and either hearing loss (N = 150) or dual sensory loss (N = 92) and their care partners (female 72.5%; male 27.5%) were considered. Participants had Alzheimer’s dementia (65%), vascular dementia (16%) or mixed dementia (19%), with mean MOCA score 16.6 (range 10 – 28). 73% of patients lived with partner or family and 24% alone. Higher caregiving intensity and higher psychological distress were observed in care partners of patients with dual sensory loss compared to care partners of people with hearing loss only after controlling for the impact of cognitive deficits, neuropsychiatric symptoms, performance on activities of daily living and demographic characteristics.ConclusionsDual sensory loss in people with dementia increases care partner distress and caregiving intensity compared to single hearing loss. Shedding light on sensory loss in dementia may pave new ways towards more effective symptom management and higher quality of life of both patients and their care partners.