Adequate Cognitive Function Research Articles

Grip strength and depressive symptoms in Chinese middle-aged and older adults: the mediating effects of cognitive function.

This study investigates the associations and mediating pathways between grip strength, cognitive function, and depression in middle-aged and elderly individuals in China. Utilizing data from the 2011 China Health and Retirement Longitudinal Study (CHARLS), we employed logistic regression and mediation analysis to examine the relationships and mediating factors between grip strength, cognitive function, and depression, while adjusting for potential confounders. The study included 6,841 participants, of whom 1,734 (25.35%) exhibited symptoms of depression. Our findings indicate that weak grip strength is significantly associated with an increased risk of depression (OR: 1.57, 95% CI: 1.32-1.87) among the middle-aged and elderly population. Conversely, good cognitive function was found to be protective against depression (OR: 0.94, 95% CI: 0.93-0.95). Grip strength indirectly affected depression through cognitive function, accounting for 9.4% of the total effect (β = -0.008, 95% CI [-0.013, -0.004]). This mediating effect was 23.8% in men (β = -0.013, 95% CI [-0.020, -0.007]); and 23.2% in those aged 60 years and over (β = -0.015, 95% CI [-0.022, -0.009]). This study highlights that weak grip strength increases risk of depressive symptoms, and adequate cognitive function can mitigate the association between weak grip strength and an increased risk of depression among middle-aged and elderly individuals in China. Psychological care for elder adults with weak grip strength and poor cognitive function should be strengthened.

Características y desacondicionamiento físico de pacientes con COVID persistente en un servicio ambulatorio de Medicina Física y Rehabilitación de Perú: un estudio transversal

Background and objectivePhysical deconditioning in Long COVID patients seems to be the main cause of impaired exercise capacity. Despite its relevance, we do not have studies to understand how it is manifesting in our country. Therefore, our objective was to describe the characteristics and physical deconditioning of Long COVID patients in a Physical Medicine and Rehabilitation (PM&R) outpatient service in Peru. Materials and methodsRetrospective cohort of Long COVID patients treated by PM&R at EsSalud between July 2 and October 27, 2021. We reviewed the medical records and extracted the variables of interest. ResultsWe included 104 patients (median age: 61years, male: 62.5%). 99% had adequate cognitive function, 76% reported comorbidities, 85.6% reported mild or no functional limitation, 91.4% reported independence or mild dependence for basic activities of daily living, and 51% underwent post-discharge physiotherapy. The most frequent signs or symptoms were pain, cough, arrhythmia, and muscle weakness. 58% had reduced aerobic power, 45.6% had reduced flexibility, 22.5% had reduced anaerobic power, and 6.2% had reduced balance. The reduction in aerobic power and balance was statistically significant in those over 60years of age. ConclusionsPhysical deconditioning was a frequent complication in Long COVID patients, especially in those assessed for aerobic power and flexibility. In those over 60 years old, a significant reduction in aerobic power and balance was observed.

Valuable interaction with cognitive remediation and optimal antipsychotics for recovery in schizophrenia (VICTORY-S): study protocol for an interventional, open-label, randomized comparison of combined treatment with cognitive remediation and lurasidone or paliperidone.

Cognitive impairment, a core feature of schizophrenia, is associated with poor outcomes. Pharmacotherapy and psychosocial treatment, when used alone, have inadequate effect sizes for cognitive impairment, leading to recent interest in combination interventions. A previous study examined the additive effect of cognitive remediation on lurasidone in patients with schizophrenia, which was negative. Although improvement in cognitive function was suggested for lurasidone, it was inconclusive because there was no antipsychotic control in the study. To clarify whether lurasidone has a meaningful impact on cognitive function in combination with cognitive remediation, we use paliperidone as a control antipsychotic in this study. We hypothesize that combination with lurasidone will improve cognitive and social function to a greater extent than paliperidone. The valuable interaction with cognitive remediation and optimal antipsychotics for recovery in schizophrenia study is a multicenter, interventional, open-label, rater-blind, randomized comparison study, comparing the effect of lurasidone plus cognitive remediation with that of paliperidone plus cognitive remediation in patients with schizophrenia. The Neuropsychological Educational Approach to Remediation (NEAR) is used for cognitive remediation. Eligible patients will be randomized 1:1 to receive lurasidone or paliperidone combined with NEAR (6 weeks antipsychotic alone followed by 24 weeks combination antipsychotic plus NEAR). The primary endpoint is the change from baseline in the tablet-based Brief Assessment of Cognition in Schizophrenia composite T-score at the end of the NEAR combination treatment period. Secondary endpoints will include change from baseline in social function, schizophrenia symptoms, and quality of life at the end of the NEAR combination treatment period. Furthermore, change from baseline to the end of the pharmacotherapy period and change from the end of the pharmacotherapy period to the end of the NEAR combination treatment period will be assessed for all endpoints. Safety will also be evaluated. Achievement of adequate cognitive function is central to supporting social function, which is a key treatment goal for patients with schizophrenia. We think this study will fill in the gaps of the previous study and provide useful information regarding treatment decisions for patients with schizophrenia. Japan Registry of Clinical Trials ID, jRCTs031200338.

NQPC-21 QOL EVALUATION IN THE TREATMENT COURSE OF CNS LYMPHOMA

Abstract Background Primary central nervous system lymphoma (PCNSL) is the second common primary malignant brain tumor. Compared to glioma, the treatment period is often longer, but there have been few research reports on QOL evaluation during the treatment yet. In this study, we retrospectively examined the QOL scores obtained during and following treatment of PCNSL to determine the association between changes in the QOL score and response to treatment, with particular interest in the issue in the evaluation over time. Methods Patients with newly-diagnosed PCNSL who were treated and evaluated for QOL by EORTC QLQ-C30/BN-20 at our facility since April 2016 were included. Results A total of 69 patients were included, with a median age of 69, and a male to female ratio of 41:32. The median KPS was 70, and the median MMSE score was 29 points, indicating that a majority of the patients who could undergo the testing retained adequate cognitive function. There were 38 patients (55.1%) who maintained CR during the QOL evaluation period, and their QOL function scores tended to be maintained above the baseline. In contrast, 31 patients (44.9%) who relapsed during the QOL evaluation period showed a tendency to decline in global health at the time of recurrence or evaluation immediately before recurrence, with the worsened symptom score reflecting the localization of recurrence. Any associations of changes in QOL score with therapeutic methods were identified. Changes in QOL scores were rather frequently observed with exacerbation of comorbidities, perhaps due to a high incidence of PCNSL in the elderly patients. Conclusions EORTC QLQ-C30/BN-20 enabled QOL evaluation that might reflect treatment effect in PCNSL. The reporting rate to the questionnaire was low in patients with substantial brain dysfunction, and QOL evaluation may also be affected by comorbidities. Further investigation of influencing factors on QOL evaluation is warranted.

Effect of Increasing Obstacle Distances Task on Postural Stability Variables During Gait Initiation in Older Nonfallers and Fallers

ObjectiveTo compare the scaling of the postural stability variables between older nonfallers and fallers during gait initiation (GI) while stepping over increasing obstacle distances. DesignCross-sectional study. SettingUniversity research laboratory. ParticipantsA sample of participants (N=24) divided into 2 groups: older nonfallers (n=12) and older fallers (n=12). Participants had no known neurologic, musculoskeletal, or cardiovascular conditions that could have affected their walking, and all were independent walkers. All the participants had an adequate cognitive function to participate as indicated by a score of more than 24 on the Mini-Mental State Examination. InterventionsNot applicable. Main Outcome MeasuresThe primary dependent variables were peak anterior-posterior (AP) center of mass (CoM)-center of pressure (CoP) separation during anticipatory postural adjustments (APAs), AP CoM-CoP separation at the toe-off, and peak AP CoM-CoP separation during the swing. Secondary dependent variables were AP trunk angle during GI. Within- and between-repeated measures analysis of variance was used to compare means between groups across different task conditions for all the dependent variables. ResultsThere was a main effect of group for peak AP CoM-CoP separation during APA (P=.018), an interaction effect between group and condition for AP CoM-CoP separation at toe-off (P=.009), and a main effect of condition for peak AP CoM-CoP separation during the swing (P<.001). We also found a main effect of group for peak AP trunk angle during the swing (P=.028). ConclusionsFor GI while stepping over increasing obstacle distances, older fallers adopt a more conservative strategy of AP CoM-CoP separation than nonfallers prior to toe-off and demonstrate increased peak AP trunk lean during the swing. AP CoM-CoP separation prior to toe-off during the GI task may be a critical marker to identify fallers and warrants additional investigation.

PD34-04 IMPACT OF COGNITIVE FUNCTION IN OLDER PATIENTS UNDERGOING SACRAL NEUROMODULATION FOR OVERACTIVE BLADDER: A PROSPECTIVE STUDY

You have accessJournal of UrologyCME1 May 2022PD34-04 IMPACT OF COGNITIVE FUNCTION IN OLDER PATIENTS UNDERGOING SACRAL NEUROMODULATION FOR OVERACTIVE BLADDER: A PROSPECTIVE STUDY Jacqueline Zillioux, Sarah Martin, Lauren Gleich, Glenn T. Werneburg, Emily Slopnick, Raymond R. Rackley, Sandip Vasavada, Bradley Gill, and Howard B. Goldman Jacqueline ZilliouxJacqueline Zillioux More articles by this author , Sarah MartinSarah Martin More articles by this author , Lauren GleichLauren Gleich More articles by this author , Glenn T. WerneburgGlenn T. Werneburg More articles by this author , Emily SlopnickEmily Slopnick More articles by this author , Raymond R. RackleyRaymond R. Rackley More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , Bradley GillBradley Gill More articles by this author , and Howard B. GoldmanHoward B. Goldman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002585.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Overactive bladder (OAB) and cognitive impairment (CI) are both increasingly prevalent with age. Given the association between anticholinergics and dementia, there is need to optimize other therapies. SUFU/AUA OAB guidelines cite adequate cognitive function as necessary for sacral neuromodulation (SNM); however, the impact of CI on SNM in older patients remains unknown. This is an interim analysis of a prospective study assessing the impact of cognitive function on outcomes of SNM for refractory OAB. METHODS: With IRB-approval, we recruited patients aged ≥60 years scheduled for test-phase (peripheral nerve evaluation (PNE) or stage 1) SNM for refractory OAB. Baseline cognitive function was assessed using the validated Montreal Cognitive Assessment (MoCA) screening test. Scores ≥26/30 are considered normal and <26 considered CI. Patients completed validated questionnaires (OAB-q SF, IIQ7, UDI-6, PGI-I) at baseline and 1-month follow-up (if implanted). Number of program adjustments performed by the patient and whether patients demonstrated appropriate device use (i.e. familiarity with communicator/programmer) were recorded. Implant rate, patient-reported questionnaires, and SNM utilization were compared based on MoCA/CI. RESULTS: 27 patients underwent test-phase (17 PNE, 10 Stage 1). Mean age was 71.9 (6.7) years. Median baseline MoCA was 24 [21.5,26.5], ranging 14-29. Although 5 (19%) patients had a pre-existing CI diagnosis, 16 (59%) demonstrated CI per MoCA. The table compares patient characteristics, baseline questionnaires and utilization outcomes based on CI. Overall, 23 (85%) patients underwent permanent implant after successful test-phase. Implant rates did not differ based on MoCA or CI. Among 15 patients with 1-month follow-up, those demonstrating appropriate device use had significantly higher MoCA scores (26 vs 17, p=0.004). Postoperative change in validated questionnaires scores, however, did not differ. CONCLUSIONS: Despite few pre-existing diagnoses, there is a high incidence of CI in older patients with OAB undergoing SNM. While implant rate did not differ based on MoCA/CI, patients with lower MoCA scores were less likely to demonstrate appropriate device use on follow-up. Impact on clinical efficacy of SNM remains to be determined. Source of Funding: Medtronic © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e560 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jacqueline Zillioux More articles by this author Sarah Martin More articles by this author Lauren Gleich More articles by this author Glenn T. Werneburg More articles by this author Emily Slopnick More articles by this author Raymond R. Rackley More articles by this author Sandip Vasavada More articles by this author Bradley Gill More articles by this author Howard B. Goldman More articles by this author Expand All Advertisement PDF DownloadLoading ...

A more unstable resting-state functional network in cognitively declining multiple sclerosis.

Cognitive impairment is common in people with multiple sclerosis and strongly affects their daily functioning. Reports have linked disturbed cognitive functioning in multiple sclerosis to changes in the organization of the functional network. In a healthy brain, communication between brain regions and which network a region belongs to is continuously and dynamically adapted to enable adequate cognitive function. However, this dynamic network adaptation has not been investigated in multiple sclerosis, and longitudinal network data remain particularly rare. Therefore, the aim of this study was to longitudinally identify patterns of dynamic network reconfigurations that are related to the worsening of cognitive decline in multiple sclerosis. Resting-state functional MRI and cognitive scores (expanded Brief Repeatable Battery of Neuropsychological tests) were acquired in 230 patients with multiple sclerosis and 59 matched healthy controls, at baseline (mean disease duration: 15 years) and at 5-year follow-up. A sliding-window approach was used for functional MRI analyses, where brain regions were dynamically assigned to one of seven literature-based subnetworks. Dynamic reconfigurations of subnetworks were characterized using measures of promiscuity (number of subnetworks switched to), flexibility (number of switches), cohesion (mutual switches) and disjointedness (independent switches). Cross-sectional differences between cognitive groups and longitudinal changes were assessed, as well as relations with structural damage and performance on specific cognitive domains. At baseline, 23% of patients were cognitively impaired (≥2/7 domains Z < −2) and 18% were mildly impaired (≥2/7 domains Z < −1.5). Longitudinally, 28% of patients declined over time (0.25 yearly change on ≥2/7 domains based on reliable change index). Cognitively impaired patients displayed more dynamic network reconfigurations across the whole brain compared with cognitively preserved patients and controls, i.e. showing higher promiscuity (P = 0.047), flexibility (P = 0.008) and cohesion (P = 0.008). Over time, cognitively declining patients showed a further increase in cohesion (P = 0.004), which was not seen in stable patients (P = 0.544). More cohesion was related to more severe structural damage (average r = 0.166, P = 0.015) and worse verbal memory (r = −0.156, P = 0.022), information processing speed (r = −0.202, P = 0.003) and working memory (r = −0.163, P = 0.017). Cognitively impaired multiple sclerosis patients exhibited a more unstable network reconfiguration compared to preserved patients, i.e. brain regions switched between subnetworks more often, which was related to structural damage. This shift to more unstable network reconfigurations was also demonstrated longitudinally in patients that showed cognitive decline only. These results indicate the potential relevance of a progressive destabilization of network topology for understanding cognitive decline in multiple sclerosis.

Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study

BackgroundInflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and cognitive impairment (CI) are associated with mortality; CRP is related to the deterioration of CI. However, it is still unknown whether these two indices predict mortality independent of each other. Furthermore, their joint effect on all-cause mortality has not been well established, especially in oldest-old adults.MethodsBased on data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we included 1447 oldest-old adults (mean age 84.7 years and 58.7% were female, weighted) with information on hs-CRP (stratified by a cutoff value of 3.0 mg/L) and cognition (quantified by Mini-Mental Status Examination (MMSE) scored according to the personal educational level) at baseline. Mortality was assessed in followed 2014 and 2017 waves. Cox proportional hazards regression models were used, with adjustment for hs-CRP and cognition (mutually controlled) and several traditional mortality risk factors.ResultsDuring a median follow-up period of 32.8 months (Q1-Q3, 9.7–59.0 months), 826 participants died. Hs-CRP [HR > 3.0 mg/L vs ≤ 3.0 mg/L: 1.64 (95% CI, 1.17, 2.30)] and cognition [HR CI vs normal: 2.30 (95% CI, 1.64, 3.21)] each was independent predictor of all-cause mortality, even after accounting for each other and other covariates. Monotonic and positive associations were observed in combined analyses, in which the highest mortality risk was obtained in elders with both high hs-CRP> 3.0 mg/L and CI [HR: 3.56 (95% CI, 2.35, 5.38)].The combined effects were stronger in male and younger oldest-old (aged 80–89 years).ConclusionHigh hs-CRP and CI, both individually and jointly, were associated with increased all-cause mortality risks in Chinese oldest-old. Intervention strategies for preventing inflammation and maintaining adequate cognitive function may be more important in male and younger oldest-old for reducing mortality risk.

Behavioral disorders: Within the limits of psychiatry or neurology? About a case

It has been a clinical case of a polimorphic psychotic disorder in a male of 26-year-old, affected by brain palsy, previously with adequate cognitive function, undergoing remarkable confusional fluctuations and a waking state apparently well-preserved. As possible comorbidities or triggers we could count on a tonsillitis and/or a depressive reaction a few days before. Serious consideration must be given to a differential diagnosis with an encephalitis but, despite the presence of an intermittent febricula, it was rejected by both units: internal medicine and neurology, after performing some complementary tests, albeit some more specific tests are still pending. His psychiatric background was also checked, which initially was orientated as a questionable bipolar disorder. At all events, symptoms stopped progressively until, almost complete remittance in the moment he was discharged from the hospital. He recovered his normal functionality. The treatment given was risperidon 2 mL/day, quetiapin 50 mg/8 h and baclofen 10 mg/12 h. This can be used as an example of how many difficulties we usually found to catalogue an acute disorder in first phases, even to encompass the clinical profile within the limits of psychiatry or neurology.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A cross-sectional study on prevalence of pain and breakthrough pain among an unselected group of outpatients in a tertiary cancer clinic

Systematic knowledge about the prevalence and the treatment effects of cancer pain in patients attending a general oncology outpatient department is limited. The purpose of this study was to investigate the prevalence of pain in a large representative cohort of patients attending a general oncology outpatient department in order to guide further screening, classification, and treatment of pain. A cross-sectional study among patients visiting the outpatient clinic with histologically verified cancer, age≥18 years, adequate cognitive function, and no surgical procedures last 24 h were included. Pain was assessed by the Brief Pain Inventory and the Alberta Breakthrough Pain Assessment Tool. Three hundred five patients were included. The mean age was 60 years, 94% had a WHO performance status of 0-1 and 59% received oncological treatment with a curative intent. The mean score for average pain last 24 h (numerical rating scale, 0-10) and current pain was 1.84 and 1.08, respectively. Twenty-two percent reported pain score of ≥4 as their average pain in the previous 24 h. Twenty-one percent reported breakthrough pain (BTP). In multivariate analyses, sleep, BTP, age, treatment intent, and comorbidity was significantly associated with mean average pain in the previous 24 h and explained 29% of the variability of average pain in the previous 24 h. Of the patients at an oncology outpatient clinic, 22% reported clinically significant pain. These findings indicate that all patients are candidates to be screened for pain and, if present, a more detailed pain diagnosis should be established before any interventions can be recommended.

Antimuscarinic use among individuals with urinary incontinence who reside in long-term care facilities

To assess appropriateness of antimuscarinic use in long-term care facilities (LTCFs) among treated and untreated urinary incontinence (UI) residents from 2007 to 2009. We conducted a retrospective analysis using the AnalytiCare(SM) database consisting of minimum data sets (MDS) assessments and prescription records of 90,660 residents from 2007 to 2009. UI (MDS H1b ≥ 1) residents with ≥ 14-day LTCF stay were identified and categorized as treated if they had ≥ 1 antimuscarinic prescription and untreated if they had no antimuscarinics. A random sample of untreated residents was matched based on treated residents' type of MDS assessment. We defined appropriate antimuscarinic use if residents had adequate cognitive function [≤ 4 on the cognitive performance scale (0 = intact to 6 = very severe impairment)] and mobility [scoring <4 on mobility for toileting scale (MDS item G1iA 0 = independent to 4 = total dependent)]. Chi-square tests were used to detect statistical difference between cohorts. A total of 5,327 residents (2,840 treated; 2,487 untreated) were selected [mean age (standard deviation) 80 (8), 81 (8) years; female (76, 65 %), respectively]. On study-defined MDS assessment, 63 % of treated and 69 % of untreated residents had UI (P < 0.01). Approximately 84 % of treated and 74 % of untreated residents may have had cognitive function and mobility sufficient for appropriate antimuscarinic use (P < 0.01). Our study identified a high percentage of LTCF residents with UI who may have been candidates for antimuscarinics. However, due to the MDS limitation, we were unable to identify overactive bladder patients among these untreated residents with UI. It is possible that untreated control residents had UI due to other factors not amenable to treatment with antimuscarinic agents. Therefore, choice of treatment for each resident needs to be individualized and carefully monitored for efficacy and adverse effects. This retrospective analysis requires prospective confirmation. Proper patient selection for antimuscarinic treatment requires careful assessment of underlying physical status including cognitive function, mobility, and comorbidities.

Taste ability in hospitalised older people compared with healthy, age‐matched controls

To investigate whether taste ability is reduced in acutely hospitalised older people compared with healthy, age-matched, non- hospitalised controls. Proper gustatory function in older people is important for quality of life and enjoyment of food. Impaired taste may contribute to weight loss in elderly. Cross- sectional study. The participants comprised two groups with age≥70years. Older people hospitalised for acute disease, home-living prior to hospital admission and with adequate cognitive function (n=174 with mean age=84 years). The controls (n=63, mean age 82years) were home-living, and healthy by their own judgement. Whole mouth gustatory function was assessed with taste strips impregnated with sweet, sour, bitter and salty taste solutions in four different concentrations each. Correct identifications were summarized, and maximum total score was 16. Total taste score was reduced in the hospitalised group compared with the control group (p=0.035). The difference was mainly due to reduced ability to detect sour and bitter taste qualities (p<0.001 and p=0.003). Acutely hospitalised older people had significantly reduced taste ability compared with non-hospitalised controls. Sour and bitter taste qualities were mostly affected. Hospital staff should pay attention to these findings when preparing food for hospitalised older people.

The Impact of Oral Health on Taste Ability in Acutely Hospitalized Elderly

ObjectiveTo investigate to what extent various oral health variables are associated with taste ability in acutely hospitalized elderly.BackgroundImpaired taste may contribute to weight loss in elderly. Many frail elderly have poor oral health characterized by caries, poor oral hygiene, and dry mouth. However, the possible influence of such factors on taste ability in acutely hospitalized elderly has not been investigated.Materials and MethodsThe study was cross-sectional. A total of 174 (55 men) acutely hospitalized elderly, coming from their own homes and with adequate cognitive function, were included. Dental status, decayed teeth, oral bacteria, oral hygiene, dry mouth and tongue changes were recorded. Growth of oral bacteria was assessed with CRT® Bacteria Kit. Taste ability was evaluated with 16 taste strips impregnated with sweet, sour, salty and bitter taste solutions in 4 concentrations each. Correct identification was given score 1, and maximum total taste score was 16.ResultsMean age was 84 yrs. (range 70–103 yrs.). Total taste score was significantly and markedly reduced in patients with decayed teeth, poor oral hygiene, high growth of oral bacteria and dry mouth. Sweet and salty taste were particularly impaired in patients with dry mouth. Sour taste was impaired in patients with high growth of oral bacteria.ConclusionThis study shows that taste ability was reduced in acutely hospitalized elderly with caries activity, high growth of oral bacteria, poor oral hygiene, and dry mouth. Our findings indicate that good oral health is important for adequate gustatory function. Maintaining proper oral hygiene in hospitalized elderly should therefore get high priority among hospital staff.

When are high-tech communicators effective in Parkinson’s disease?

This report describes a 63-year-old woman with Parkinson's disease showing loss of intelligibility of speech and severely impaired handwriting, despite undergoing physical and speech therapies. As the patient had sufficient residual motor abilities and adequate cognitive function and motivation, a computer-based communication aid with a software program for word prediction and voice output was tested, and was prescribed after a training period. One year later, the patient was still using the customized device to communicate and for leisure time, showing a high degree of satisfaction with the aid (assessed by QUEST 2.0), which had a positive impact on her well-being and quality of life (assessed by Psychosocial Impact of Assistive Devices Scales). In conclusion, in selected patients with Parkinson's disease, high-tech augmentative and alternative communication devices may be considered, tested, and prescribed after a positive training period. Follow-ups are necessary to monitor the effectiveness of the assistive device and respond to specific patient needs that may arise with using the device.

Role of cognitive function in assessing informed consent for endoscopy

Background: Patient understanding of the consent process is often suboptimal and the reasons for this are poorly understood. In particular the role of cognitive function in assessing the level of...

Relationships between dietary intake and cognitive function level in Korean elderly people

We examined the relationship between dietary intake and cognitive performance in Korean elderly people. Data for dietary intake, anthropometric measurements and cognitive function tests were collected and the relationships of the variables were analyzed. A random sample of 210 men and 239 women in Korea, aged 60 and over, was selected. Subjects were free-living elderly people who had not experienced major cognitive function impairment. Main outcome measures, 24 h dietary recall method, food behaviour variables, anthropometrics indices, health variables, and Kwon's Mini-Mental State Examination for Koreans (MMSE-K) for cognitive function test. The prevalence rate of poor cognitive function (MMSE-K score ≤19) of Korean elderly was 22.3%: women with poor cognitive function had a higher rate (31.0%) than that in men (12.3%). Cognitive ability was related negatively with age and positively with school education level. Female subjects of poor cognitive function had significantly lower intakes of total amount of foods, cereals, vegetables, fruits, milk, spices, and also, energy, protein, fat, carbohydrate, Ca, P, Fe, vitamin A, thiamin, riboflavin, and niacin than those of the normal cognitive score (≥24) group ( P<0.05). Male subjects of poor cognitive function had significantly lower intakes of fruits, fiber, and vitamin C than the normal subjects ( P<0.05). The MMSE-K score of female subjects showed a significant positive correlation with total amount of foods, cereals, beans, fruits, milk, oil, spices, and energy, protein, fat, carbohydrate, Ca, Fe, P, riboflavin and niacin intakes. The consumption of adequate nutrients, by taking sufficient amounts and variety of foods, may be important in maintaining adequate cognitive function in elderly Koreans. Public Health (2001) 115, 133–138.

Relationships between dietary intake and cognitive function level in Korean elderly people

We examined the relationship between dietary intake and cognitive performance in Korean elderly people. Data for dietary intake, anthropometric measurements and cognitive function tests were collected and the relationships of the variables were analyzed. A random sample of 210 men and 239 women in Korea, aged 60 and over, was selected. Subjects were free-living elderly people who had not experienced major cognitive function impairment. Main outcome measures, 24 h dietary recall method, food behaviour variables, anthropometrics indices, health variables, and Kwon's Mini-Mental State Examination for Koreans (MMSE-K) for cognitive function test. The prevalence rate of poor cognitive function (MMSE-K score ≤19) of Korean elderly was 22.3%: women with poor cognitive function had a higher rate (31.0%) than that in men (12.3%). Cognitive ability was related negatively with age and positively with school education level. Female subjects of poor cognitive function had significantly lower intakes of total amount of foods, cereals, vegetables, fruits, milk, spices, and also, energy, protein, fat, carbohydrate, Ca, P, Fe, vitamin A, thiamin, riboflavin, and niacin than those of the normal cognitive score (≥24) group (P<0.05). Male subjects of poor cognitive function had significantly lower intakes of fruits, fiber, and vitamin C than the normal subjects (P<0.05). The MMSE-K score of female subjects showed a significant positive correlation with total amount of foods, cereals, beans, fruits, milk, oil, spices, and energy, protein, fat, carbohydrate, Ca, Fe, P, riboflavin and niacin intakes. The consumption of adequate nutrients, by taking sufficient amounts and variety of foods, may be important in maintaining adequate cognitive function in elderly Koreans. Public Health (2001) 115, 133–138.