Cognitive Impairment In Elderly Patients Research Articles

Study on correlation between perioperative cognitive function and nutritional status in elderly patients with gastric cancer

Objective: To investigate the cognitive function and nutritional status of elderly patients with gastric cancer during perioperative period, and to analyze their correlation. Methods: Aged patients undergoing gastric cancer surgery in The Affiliated Cancer Hospital of Shandong First Medical University from March to October 2021 were selected as the subjects of this study. The monitoring data of cognitive function and nutritional status were retrospectively analyzed from 1 to 3 days before surgery, 1 and 3 days after surgery, 7 days after surgery (before discharge) and 30 days after surgery to analyze the correlation between cognitive function and nutritional status in elderly patients with gastric cancer. Results: the incidence of mild cognitive impairment in elderly patients with gastric cancer was 52.43 %, the visual space of the two groups' (mild cognitive impairment) ability of execution, name, attention, language, abstract thinking, delayed memory and cognitive function scores were lower than 1 set of directional force (cognitive function in normal group), statistically significant difference (P < 0.05). The nutritional status of elderly patients with gastric cancer was lower than that of healthy elderly group at the same period (P < 0.05). The scores of visual spatial executive function, name, attention, delayed memory, orientation and total score of cognitive function in elderly gastric cancer patients were positively correlated with nutritional status (P < 0.05). Conclusions: The cognitive function and nutritional status of elderly patients with gastric cancer are both in a low state during treatment and a higher level of cognitive function can help patients maintain a more correct nutritional cognition, and the nutritional status of patients will be relatively better. There is a positive correlation between cognitive function and nutritional status in elderly patients with gastric cancer, which should be paid attention to in the treatment.

Clusters of cognitive performance predict long-term cognitive impairment in elderly patients with subjective memory complaints and healthy controls.

Patients with subjective memory complaints (SMC) may include subgroups with different neuropsychological profiles and risks of cognitive impairment. Cluster analysis was performed on two datasets (n: 630 and 734) comprising demographic and neuropsychological data from SMC and healthy controls (HC). Survival analyses were conducted on clusters. Bayesian model averaging assessed the predictive utility of clusters and other biomarkers. Two clusters with higher and lower than average cognitive performance were detected in SMC and HC. Assignment to the lower performance cluster increased the risk of cognitive impairment in both datasets (hazard ratios: 1.78 and 2.96; Plog-rank: 0.04 and<0.001) and was associated with lower hippocampal volumes and higher tau/amyloid beta 42 ratios in cerebrospinal fluid. The effect of SMC was small and confounded by mood. This study provides evidence of the presence of cognitive clusters that hold biological significance and predictive value for cognitive decline in SMC and HC. Patients with subjective memory complaints include two cognitive clusters. Assignment to the lower performance cluster increases risk of cognitive impairment. This cluster shows a pattern of biomarkers consistent with incipient Alzheimer's disease pathology. The same cognitive cluster structure is found in healthy controls. The effect of memory complaints on risk of cognitive decline is small and confounded.

Dysregulation of the Gut Microbiota Contributes to Sevoflurane-Induced Cognitive Dysfunction in Aged Mice by Activating the NLRP3 Inflammasome.

Postoperative cognitive dysfunction (POCD), a common complication in elderly patients after surgery, seriously affects patients' quality of life. Long-term or repeated inhalation of sevoflurane can cause neuroinflammation, which is a risk factor for POCD. However, the underlying mechanism needs to be further explored. Recent research had revealed a correlation between neurological disorders and changes in the gut microbiota. Dysfunction of the gut microbiota is involved in the occurrence and development of central nervous system diseases. Here, we found that cognitive dysfunction in aged mice induced by sevoflurane exposure (3%, 2 hours daily, for 3 days) was related to gut microbiota dysbiosis, while probiotics improved cognitive function by alleviating dysbiosis. Sevoflurane caused a significant decrease in the abundance of Akkermansia (P<0.05), while probiotics restored the abundance of Akkermansia. Compared to those in the control group, sevoflurane significantly increased the expression of NLRP3 inflammasome-associated proteins in the gut and brain in the sevoflurane-exposed group, thus causing neuroinflammation and synaptic damage, which probiotics can mitigate (con vs. sev, P < 0.01; p+sev vs. sev, P < 0.05). In conclusion, for the first time, our study revealed that dysbiosis of the gut microbiota caused by sevoflurane anesthesia contributes to the NLRP3 inflammasome-mediated neuroinflammation and cognitive dysfunction from the perspective of the gut-brain axis. Perhaps postoperative cognitive impairment in elderly patients can be alleviated or even prevented by regulating the gut microbiota. This study provides new insights and methods for the prevention and treatment of cognitive impairment induced by sevoflurane.

Evaluation of a multimodal diagnostic algorithm for prediction of cognitive impairment in elderly patients with dizziness.

The current diagnostic workup for chronic dizziness in elderly patients often neglects neuropsychological assessment, thus missing a relevant proportion of patients, who perceive dizziness as a subjective chief complaint of a concomitant cognitive impairment. This study aimed to establish risk prediction models for cognitive impairment in chronic dizzy patients based on data sources routinely collected in a dizziness center. One hundred patients (age: 74.7 7.1years, 41.0% women) with chronic dizziness were prospectively characterized by (1) neuro-otological testing, (2) quantitative gait assessment, (3) graduation of focal brain atrophy and white matter lesion load, and (4) cognitive screening (MoCA). A linear regression model was trained to predict patients' total MoCA score based on 16 clinical features derived from demographics, vestibular testing, gait analysis, and imaging scales. Additionally, we trained a binary logistic regression model on the same data sources to identify those patients with a cognitive impairment (i.e., MoCA < 25). The linear regression model explained almost half of the variance of patients' total MoCA score (R2 = 0.49; mean absolute error: 1.7). The most important risk-predictors of cognitive impairment were age (β = -0.75), pathological Romberg's sign (β = -1.05), normal caloric test results (β = -0.8), slower timed-up-and-go test (β = -0.67), frontal (β = -0.6) and temporal (β = -0.54) brain atrophy. The binary classification yielded an area under the curve of 0.84 (95% CI 0.70-0.98) in distinguishing between cognitively normal and impaired patients. The need for cognitive testing in patients with chronic dizziness can be efficiently approximated by available data sources from routine diagnostic workup in a dizziness center.

Effectiveness of Tai Chi as a non-invasive intervention for mild cognitive impairment in the elderly: A comprehensive review and meta-analysis.

The aging population warrants the increase of mild cognitive impairment (MCI) prevalence, a condition that could progress to dementia. Efforts have been made to improve the MCI and prevent its progression, including the introduction of Tai Chi, a Chinese traditional exercise. The aim of this systematic review and meta-analysis was to evaluate the efficacy of Tai Chi in attenuating MCI among the elderly population. Records investigating the effect of Tai Chi exercise intervention on cognitive function among elderly patients were searched systematically from PubMed, ScienceDirect, Google Scholar, and Europe PMC as of April 13, 2023. The risk of bias (RoB 2.0) quality assessment was employed in the quality appraisal of the studies included. Review Manager 5.4.1 was used for data extraction and meta-analysis, where the standard mean difference (SMD) and 95% confidence interval (95%CI) were computed. Eight randomized control trials with a total of 1379 participants were included in this meta-analysis. Six trials assessed Montreal Cognitive Assessment scores, where its pooled analysis suggested that Tai Chi was as effective as conventional exercise (SMD=0.15, 95%CI: -0.11 to 0.40, p=0.26). However, pooled analysis of the Mini-Mental Status Examination suggested that Tai Chi intervention more effectively improved cognitive function and reduced the rate of cognitive impairment in elderly patients (SMD=0.36, 95%CI: 0.18 to 0.54, p<0.01) as compared to the control group. This systematic review and meta-analysis suggest that, in some extent, Tai Chi is efficacious in improving cognitive function and slowing down the rate of cognitive impairment among elderly patients.

Correlation between fat-to-muscle mass ratio and cognitive impairment in elderly patients with type 2 diabetes mellitus: a cross-sectional study

BackgroundFat to muscle mass ratio (FMR), a novel index integrating fat and muscle composition, has garnered attention in age-related conditions such as type 2 diabetes mellitus (T2DM) and neurodegenerative diseases. Despite this research on the relationship between FMR and cognitive impairment (CI) in T2DM remains scarce. This study aimed to investigate the sex-specific association between FMR and CI in elderly T2DM patients.MethodsA total of 768 elderly (> 60 years) T2DM in-patients (356 men and 412 women) were recruited from the Department of Endocrinology at Tianjin Nankai University affiliated hospital. Bioelectrical Impedance Analysis (BIA) was used to assess body composition, and Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive performance. T2DM patients were categorized into normal cognitive function (NC) and cognitive impairment (CI) groups based on MoCA scores and stratified by sex. Binary logistic regression was employed to examine the association between FMR and CI.ResultsAmong the participants, 42.7% of men and 56.3% of women experienced cognitive deterioration. Women with CI exhibited lower body mass index (BMI) and skeletal muscle mass index (SMI), while men with cognitive disorders showed lower SMI, FMR, and higher fat mass index (FMI). FMR was consistently unrelated to cognition in females, irrespective of adjustment made. However, in males, FMR was significantly associated with an increasing risk of cognitive dysfunction after adjusting for demographic and clinical variables (OR: 1.175, 95% CI: 1.045–1.320, p = 0.007). Furthermore, for each 0.1 increase in FMR, the incidence of CI rose by 31.1% after additional adjustment for BMI. In males, the prevalence of CI increased sequentially across FMR quartiles (p < 0.05).ConclusionElderly T2DM men with high FMR had unfavorable cognitive function. FMR is independently associated with an increased risk of CI in male T2DM patients regardless of BMI.

A new nomogram model for the individualized prediction of mild cognitive impairment in elderly patients with type 2 diabetes mellitus.

A high risk of developing mild cognitive impairment (MCI) is faced by elderly patients with type 2 diabetes mellitus (T2DM). In this study, independent risk factors for MCI in elderly patients with T2DM were investigated, and an individualized nomogram model was developed. In this study, clinical data of elderly patients with T2DM admitted to the endocrine ward of the hospital from November 2021 to March 2023 were collected to evaluate cognitive function using the Montreal Cognitive Assessment scale. To screen the independent risk factors for MCI in elderly patients with T2DM, a logistic multifactorial regression model was employed. In addition, a nomogram to detect MCI was developed based on the findings of logistic multifactorial regression analysis. Furthermore, the accuracy of the prediction model was evaluated using calibration and receiver operating characteristic curves. Finally, decision curve analysis was used to evaluate the clinical utility of the nomogram. In this study, 306 patients were included. Among them, 186 patients were identified as having MCI. The results of multivariate logistic regression analysis demonstrated that educational level, duration of diabetes, depression, glycated hemoglobin, walking speed, and sedentary duration were independently correlated with MCI, and correlation analyses showed which influencing factors were significantly correlated with cognitive function (p <0.05). The nomogram based on these factors had an area under the curve of 0.893 (95%CI:0.856-0.930)(p <0.05), and the sensitivity and specificity were 0.785 and 0.850, respectively. An adequate fit of the nomogram in the predictive value was demonstrated by the calibration plot. The nomogram developed in this study exhibits high accuracy in predicting the occurrence of cognitive dysfunction in elderly patients with T2DM, thereby offering a clinical basis for detecting MCI in patients with T2DM.

IDF23-0082 Mild cognitive impairment in elderly patients with diabetes: effects of changes on BMI and appetite

IDF23-0082 Mild cognitive impairment in elderly patients with diabetes: effects of changes on BMI and appetite

Retrospective study for correlation analysis of nutritional status with osteoporosis, sarcopenia and cognitive impairment in elderly patients with coronary heart disease.

Coronary heart disease (CHD) is an abbreviation of coronary atherosclerotic heart disease, which remains challenging for diagnosis and treatment. Current study aims to explore the correlation between geriatric nutritional risk index (GNRI) and osteoporosis, sarcopenia, cognitive dysfunction in elderly patients with CHD, and to analyze the clinical diagnostic value of GNRI in the above complications. A total of 92 elderly patients with CHD treated in Suzhou Ninth People's Hospital from January 2020 to October 2023 were retrospectively collected as the experimental group, and 68 non-CHD subjects matched for sex and age in the same period of physical examination were randomly selected as the control group. Osteoporosis, sarcopenia and cognitive dysfunction were analyzed in all patients, and the correlation between GNRI and these indices in different populations was analyzed by Spearman's rank correlation. The diagnostic efficacy of GNRI in osteoporosis, sarcopenia, and cognitive impairment was analyzed by ROC curves. There was no significant difference in age, sex distribution, body mass index (BMI) and serum biological indexes between the elderly patients with CHD and the control group (all P > 0.05). Correlation analysis showed that GNRI level was positively correlated with bone mineral content (BMC), bone mineral density (BMD) T value and osteocalcin (OCN) (All r > 0, P < 0.05). In addition, GNRI levels were positively correlated with skeletal muscle mass (ASMI), grip strength and calf circumference (CC) (All r > 0, P < 0.05). However, there was no significant correlation between GNRI levels and cognitive dysfunction-related indicators (P > 0.05). In the elderly and elderly with CHD, the diagnostic AUC of GNRI was 0.875 and 0.862 in osteoporosis, and 0.912 and 0.932 in sarcopenia, respectively. The level of GNRI is significantly correlated with osteoporosis and sarcopenia. GNRI level, as an auxiliary diagnostic tool in elderly patients with CHD, exerts important clinical significance for early detection of the risk of complications, such as osteoporosis and sarcopenia.

Linear brain measurement: a new screening method for cognitive impairment in elderly patients with cerebral small vessel disease.

The old adults have high incidence of cognitive impairment, especially in patients with cerebral small vessel disease (CSVD). Cognitive impairment is not easy to be detected in such populations. We aimed to develop clinical prediction models for different degrees of cognitive impairments in elderly CSVD patients based on conventional imaging and clinical data to determine the better indicators for assessing cognitive function in the CSVD elderly. 210 CSVD patients were screened out by the evaluation of Magnetic Resonance Imaging (MRI). Then, participants were divided into the following three groups according to the cognitive assessment results: control, mild cognitive impairment (MCI), and dementia groups. Clinical data were collected from all patients, including demographic data, biochemical indicators, carotid ultrasound, transcranial Doppler (TCD) indicators, and linear measurement parameters based on MRI. Our results showed that the brain atrophy and vascular lesions developed progressive worsening with increased degree of cognitive impairment. Crouse score and Interuncal distance/Bitemporal distance (IUD/BTD) were independent risk factors for MCI in CSVD patients, and independent risk factors for dementia in CSVD were Crouse Score, the pulsatility index of the middle cerebral artery (MCAPI), IUD/BTD, and Sylvian fissure ratio (SFR). Overall, the parameters with high performance were the IUD/BTD (OR 2.28; 95% CI 1.26-4.10) and SFR (OR 3.28; 95% CI 1.54-6.91), and the AUC (area under the curve) in distinguishing between CSVD older adults with MCI and with dementia was 0.675 and 0.724, respectively. Linear brain measurement parameters had larger observed effect than other indexes to identify cognitive impairments in CSVD patients. This study shows that IUD/BTD and SFR are good predictors of cognitive impairments in CSVD elderly. Linear brain measurement showed a good predictive power for identifying MCI and dementia in elderly subjects with CSVD. Linear brain measurement could be a more suitable and novel method for screening cognitive impairment in aged CSVD patients in primary healthcare facilities, and worth further promotion among the rural population.

Clinical characteristics and healthcare utilisation associated with undiagnosed cognitive impairment in elderly patients with diabetes in a primary care setting: a population-based cohort study

ObjectivesThe objective of this study is to report the prevalence, clinical characteristics and healthcare utilisation of patients with type 2 diabetes (T2DM) and previously undiagnosed cognitive impairment who were identified...

Association between serum omega-3 PUFAs levels and cognitive impairment in never medically treated first-episode patients with geriatric depression: A cross-sectional study

BackgroundGeriatric depression increases the public health burden and health care costs, reduces quality of life. Studies have shown the association between ω-3 PUFAs levels and inflammatory markers levels and depression, but few have explored the relationship between omega-3 PUFAs, inflammatory markers, and cognitive function in geriatric depression. This study aimed to compare the differences in ω-3 PUFAs levels and inflammatory markers between geriatric depression with cognitive impairment (CI) and those without CI. MethodsA total of three hundred and five elderly patients were recruited. In addition to collecting basic information, their blood specimens were collected to detect serum EPA, DHA, AA, TC, LDL-C, IL-6, TNF-α, and hs-CRP levels. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and The Montreal cognitive assessment (MoCA) were used to assess their depression, anxiety, and cognitive function, respectively. ResultsCompared to those without CI, geriatric depression patients with CI had higher serum TC, LDL-C levels, lower EPA, DHA, and AA levels, and more elevated IL-6, TNF-α, and hs-CRP levels (all P < 0.05). Further linear regression analysis showed that EPA, DHA, and TNF-α, hs-CRP levels were significantly associated with the occurrence and the severity of CI. LimitationsNo causal relationship could be drawn due to the cross-sectional design. ConclusionsOmega-3 PUFAs and inflammatory factors levels may predict CI in elderly patients with MDD in the future. Our findings suggest that ω-3 PUFAs (EPA and DHA) and inflammatory factors (TNF-α and CRP) may predict the occurrence and the severity of CI among elderly MDD patients.

Development of an improved ELISA method based on gold nanoparticles to evaluate the correlation of serum occludin and zonula occludin-1 (ZO-1) levels with cognitive impairment in elderly patients with acute cerebral infarction

The present study evaluated an improved Enzyme linked immunosorbent assay (ELISA) method based on gold nanoparticles by investigating the correlations of measured serum occludin and zonula occludin-1 (ZO-1) levels with cognitive impairment in elderly patients with acute cerebral infarction (ACI). The present study comprised a total of 98 patients with ACI that were divided into patients with normal cognitive function (normal group) and patients with cognitive impairment (PSCI group) according to mini-mental state examination (MMSE) scores. Serum levels of triglycerides, total cholesterol, and low-density lipoprotein were measured using an automatic biochemical analyzer. Serum occludin and ZO-1 levels in both groups were measured using a modified ELISA assay with nanogold particles. Neurological function in elderly patients with ACI was assessed using the National Institutes of Health Stroke Scale (NIHSS) score. Pearson’s correlation coefficient was calculated for the correlations between serum occludin levels, serum ZO-1 levels, and cognitive impairment in elderly patients with ACI. Receiver operating characteristics (ROC) curves were used to analyze the diagnostic value of serum occludin and ZO-1 levels in detecting cognitive impairment in elderly patients with ACI. Logistic regression analysis was used to identify factors associated with cognitive impairment in elderly patients with ACI. In the PSCI group, a significantly higher proportion of patients had hypertension, coronary heart disease, and diabetes compared to the normal group. Serum occludin and ZO-1 levels were significantly lower in the PSCI group compared to the normal group (P &lt;0.05). Serum occludin and ZO-1 levels in elderly patients with ACI were negatively associated with NIHSS score (P &lt;0.05). Receiver operating characteristic analysis demonstrated that the area under the curve (AUC) of serum occludin and ZO-1 in detecting cognitive impairment in elderly patients with ACI was 0.926 and 0.824 respectively, with a combined AUC of 0.945 indicating a synergistic effect in detecting cognitive impairment. Logistic regression analysis showed that hypertension, diabetes, coronary heart disease, and lower serum occludin, and ZO-1 levels were all independent risk factors for cognitive impairment in elderly patients with ACI. Lower serum levels of occludin and ZO-1 level had diagnostic value in detecting cognitive impairment in elderly patients with ACI and may have utility as an auxiliary diagnostic index for cognitive dysfunction in patients with ACI.

Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment and self-reported side effects in the euthymic phase of bipolar disorders: Results from the FACE-BD cohort

Bipolar disorders (BD) are characterized by cognitive impairment during the euthymic phase, to which treatments can contribute. The anticholinergic properties of medications, i.e., the ability of a treatment to inhibit cholinergic receptors, are associated with cognitive impairment in elderly patients and people with schizophrenia but this association has not been well characterized in individuals with remitted BD. Moreover, the validity of only one anticholinergic burden scale designed to assess the anticholinergic load of medications has been tested in BD. In a literature review, we identified 31 existing scales. We first measured the associations between 27 out of the 31 scales and objective cognitive impairment in bivariable regressions. We then adjusted the bivariable models with covariates: the scales significantly associated with cognitive impairment in bivariable and multiple logistic regressions were defined as having good concurrent validity to assess cognitive impairment. In a sample of 2,031 individuals with euthymic BD evaluated with a neuropsychological battery, two scales had good concurrent validity to assess cognitive impairment, whereas chlorpromazine equivalents, lorazepam equivalents, the number of antipsychotics, or the number of treatments had not. Finally, similar analyses with subjective anticholinergic side-effects as outcome variables reported 14 scales with good concurrent validity to assess self-reported peripheral anticholinergic side-effects and 13 to assess self-reported central anticholinergic side-effects. Thus, we identified valid scales to monitor the anticholinergic burden in BD, which may be useful in estimating iatrogenic cognitive impairment in studies investigating cognition in BD.

Relationship between homocysteine and cognitive impairment in elderly patients with chronic kidney disease

&lt;b&gt;Aim:&lt;/b&gt; To investigate the association of serum homocysteine levels with cognitive function in elderly patients with chronic kidney disease (CKD).&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; A case-control study on 200 elderlies &amp;gt;60 years who were distributed into two groups: group 1 (cases): 100 patients with CKD and group 2 (controls): 100 subjects who do not have CKD. All subjects undergo comprehensive geriatric assessment, cognitive assessment, and biochemical investigations including serum homocysteine.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The odds ratio of having impaired clinical dementia rating scores is 3.1 for CKD cases compared to controls. CKD patients have almost 3 times the risk of having cognitive impairment [OR=3.1; 95% CI (1.6-6.0)]. The mean serum homocysteine (18.2 μmol/L) among CKD showed a highly statistically significance compared to controls (10.1 μmol/L). Performance of multiple cognitive domains was reduced in association with elevated homocysteine levels. By using linear regression model for the factors independently related to cognitive performance among studied CKD cases, it was found that diabetes mellitus, educational level, age, and serum homocysteine level were strongly associated with consortium to establish a registry for Alzheimer’s disease neuropsychological battery total scores. Respecting the percentage variance explained by each significant variable (R&lt;sup&gt;2&lt;/sup&gt;), serum homocysteine level is an independent significant variable predictor with the total scores.&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; The main features of cognitive impairment in CKD patients are executive dysfunction and memory impairment. Poor cognitive function in CKD patients was related with a higher homocysteine level independently.

P-79 Evaluation of a hierarchical multimodal diagnostic algorithm for prediction of cognitive impairment in elderly patients with dizziness

P-79 Evaluation of a hierarchical multimodal diagnostic algorithm for prediction of cognitive impairment in elderly patients with dizziness

WCN23-0678 Cognitive impairment in elderly patients with chronic kidney disease and its association with immune dysregulation and chronic inflammation

WCN23-0678 Cognitive impairment in elderly patients with chronic kidney disease and its association with immune dysregulation and chronic inflammation

Evaluation of the Effectiveness of Neurocognitive Rehabilitation of Patients with Mild Cognitive Decline under Restrictions during the COVID-19 Pandemic

Background: the development of programs for the correction of cognitive impairment in elderly patients with various types of mild cognitive decline is an urgent task of geriatric medicine and clinical psychology. The aim of the study was to conduct neuropsychological and psychometric evaluation of the results of a modified neurorehabilitation program (combination of full time and part time studies) in patients of the “Memory Clinic”. Patients and methods: a total of 114 patients (mean age 73 years) with mild cognitive impairment was studied. Neuropsychological and psychometric evaluation of the dynamics of the cognitive sphere in patients with mild cognitive decline (MCI) before and after participation (week 6) in the full-time/part-time neurorehabilitation program at the “Memory Clinic” was carried out. For psychometric assessment, the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used. The neuropsychological study was carried out using the “Express Method for the Study of Cognitive Functions at a Late Age” (N.K. Korsakova et al.). For psychometric assessment, the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used. The neuropsychological study was carried out using the “Express Method for the Study of Cognitive Functions at a Late Age” (N.K. Korsakova, E.Yu. Balashova, I.F. Roshchina). Results: using the method of multivariate analysis of variance (MANOVA), a statistically significant effect (p &lt; 0.05) of the neurorehabilitation program on psychometric tests (MMSE, MoCA) and on the total score of the “Express Methods for the Study of Cognitive Functions at a Late Age”, as well as on its subscales —verbal memory, visual memory, semantic memory, dynamic, spatial and regulatory praxis was detected. Conclusions: a psychometric and neuropsychological study showed the effectiveness of a full time/part-time neurocognitive rehabilitation program for patients with mild cognitive decline under conditions of limited visits to the Memory Clinic during the COVID-19 pandemic.

Fascia iliaca compartment block can reduce the incidence of early post-operative cognitive impairment in elderly patients with high-risk hip replacement.

In this study, we aimed to observe the effects of ultrasound-guided fascia iliaca compartment block (FICB) combined with hypobaric spinal anesthesia on post-operative pain and cognitive function in elderly patients with high-risk hip replacement. A total of 84 elderly patients-aged 65-85 years, with American Society of Anesthesiologists physical status III-IV, and scheduled for hip arthroplasty between September 2021 and May 2022-were selected. One or more organs with moderate to severe impairment were included in all patients. The patients were randomly divided into a hypobaric spinal anesthesia group (group C, control group) and an ultrasound-guided FICB combined with hypobaric spinal anesthesia group (group E, experimental group). Group C was given 3.5 mL of 0.32% ropivacaine hypobaric spinal anesthesia, and group E received ultrasound-guided FICB combined with 3.5 mL of 0.32% ropivacaine hypobaric spinal anesthesia. The patients were compared using the visual analog scale (VAS) for pain, Harris hip function score, and simple Mini-Mental State Examination (MMSE) scale. Blood β-amyloid (Aβ) and neuronal microtubule-associated protein (tau) levels were measured. We compared intraoperative conditions and post-operative complications between the two groups to assess the effects of FICB combined with hypobaric spinal anesthesia on post-operative pain and cognitive function in elderly patients with high-risk hip replacement. At 1 and 3 days after the operation, patients in group C had significantly higher VAS and lower MMES scores than those in group E. The differences were statistically significant at 1 (P < 0.01) and 3 (P < 0.05) days after the operation. At 1 day after operation, the Harris score of patients in group C was significantly lower than that of patients in group E (P < 0.05). The Aβ and tau levels of patients in group C were significantly higher than those of patients in group E at 1 day after the operation (P < 0.01). The Aβ levels of patients in group C were significantly higher than those of patients in group E at 3 days after the operation (P < 0.05). The intraoperative conditions and post-operative complication rates did not differ significantly between the two groups. At 1 day before and 5 days after the operation, there was no difference in any of the indicators. By lowering pain and managing Aβ and tau protein concentrations, FICB can successfully lower the incidence of early post-operative cognitive impairment in elderly patients with high-risk hip replacement. www.chictr.org.cn, identifier: ChiCTR2100051162.

Abstract 14438: Longitudinal Real World Study of Blood Pressure and Cerebral Arterial Stenosis on Elderly Cognitive Impairment Based on the Artificial Intelligence Analysis of Serial Brain Magnetic Resonance Angiography

Background: Abnormal blood pressure (BP) is one of the most common modified risk factors for the development of cognitive impairment (CI) with increasing aging population. Objective: This study aims to investigate the association between risk factors and CI in elderly patients based on artificial intelligence (AI) analysis of BP measurements and brain magnetic resonance angiography (MRA). Methods: A total of 3221 elderly individuals undergone brain MRA were recruited into the nested case-control study from 2007 to 2021. Patients were divided into two groups according to diagnosis with or without CI. Data were collected before diagnosing CI. The stenosis rate of cerebral arteries was calculated by AI analysis of brain MRA. Four machine learning modalities were applied to establish predictive models. Results: A total of 416 cases (mean age 84.47 ± 6.50 years old) with or without CI were finally recruited into the study after matching with age and gender. Mean follow-up time was 3.46 ± 3.19 years. The number of BP measurements was 56.98 ± 77.94 times. In the univariate logistic regression model, high systolic blood pressure (SBP) (OR 1.029, 95% CIs 1.010-1.049), pulse pressure (PP) (OR 1.043, 95% CIs: 1.021-1.065) and pulse pressure index (PPI) (OR 3588.920, 95% CIs: 44.392-290148.336) increased the risk of CI. Based on various mean BP parameters, the predictive ability of the support vector machine (SVM) was improved after adding cerebral arterial stenosis rate (AUC 0.781, 95% CIs 0.639~0.923). Conclusion: Abnormal SBP, PP and PPI were risk factors for CI in the elderly Chinese population. Adding the cerebral arterial stenosis rate of internal carotid artery and posterior cerebral artery the predictive ability of SVM model of various mean BP parameters for the risk of CI was improved.