Cognitive Impairment In Older People Research Articles

Association between Sarcopenia, Falls, and Cognitive Impairment in Older People: A Systematic Review with Meta-Analysis.

With the aging process, elderly people present changes in their bodies that can lead them to suffer several geriatric syndromes. The present study aimed to analyze and synthesize the literature produced concerning the association of sarcopenia with falls in elderly people with cognitive impairment. This is a systematic review study on etiology and risk, conducted according to the JBI methodology using the Medline (Pubmed), Cinahl, Embase, Scopus, and Web of Science databases. The gray literature search was conducted in the CAPES Brazilian Digital Library of Theses and Dissertations, Google Scholar, Networked Digital Library of Theses and Dissertations (NDLTD), EBSCO Open Dissertations, DART-e, and ACS Guide to Scholarly Communication. The identification of the association between the variables was extracted from the articles themselves (Odds Ratio and the 95% Confidence Intervals). Four articles published between 2012 and 2021 were included in this review. A prevalence of falls was identified, ranging from 14.2% to 23.1%, of cognitive impairment ranging from 24.1% to 60.8%, and of sarcopenia ranging from 6.1 to 26.6%. The meta-analysis found that elderly people with cognitive impairment who suffer falls are at a 1.88 times greater risk of presenting sarcopenia (p = 0.01). There is evidence of an association between the variables, but it is necessary to conduct follow-up studies to support this association as well as other factors that may influence the senescence and senility process.

Cognitive impairment as a comorbidity of epilepsy in older adults: Analysis of global and domain-specific cognition.

This study aimed to explore the association between epilepsy and cognitive impairment and to determine the factors associated with cognitive impairment in older people with epilepsy. People with epilepsy and controls aged ≥50 years were recruited and their global and domain-specific cognitive functions were evaluated by a comprehensive neuropsychological battery. Clinical characteristics were obtained from medical records. Analysis of covariance was used to examine the difference of cognition between two groups, after adjusting for age, gender, education years, hypertension, diabetes, and heart disease. A multiple linear regression model was used to explore the potential impact factors of cognitive functions among people with epilepsy. This study recruited 90 people with epilepsy and 110 controls. The proportion of cognitive impairment among older adults with epilepsy was 62.2%, which was significantly higher than controls (25.5%, p < .001). People with epilepsy performed worse on global cognition (p < .001), especially in domains of memory (p < .001), executive function (p < .001), language (p < .001), and attention (p = .031). Among older adults with epilepsy, age was negatively correlated with the scores of memory (β = -.303, p = .029), executive function (β = -.354, p = .008), and attention (β = -.558, p < .001). Females performed better on executive function (β = -.350, p = .002) than males. Education years had a positive correlation with global cognition (β = .314, p = .004). Number of antiseizure medications was also negatively correlated with scores of spatial construction function (β = -.272, p = .019). Our results indicated that cognitive impairment was a major comorbidity of epilepsy. Number of antiseizure medications is suggested as a potential risk factor of impaired cognition in older people with epilepsy.

Testing the cognitive effects of tadalafil. Neuropsychological secondary outcomes from the PASTIS trial

Cerebral small vessel disease (SVD) is a major cause of cognitive impairment in older people. As secondary endpoints in a phase-2 randomised clinical trial, we tested the effects of single administration of a widely-used PDE5 inhibitor, tadalafil, on cognitive performance in older people with SVD. In a double-blinded, placebo-controlled, cross-over trial, participants received tadalafil (20 mg) and placebo on two visits ≥ 7 days apart (randomised to order of treatment). The Montreal Cognitive Assessment (MOCA) was administered at baseline, alongside a measure to estimate optimal intellectual ability (Test of Premorbid Function). Then, before and after treatment, a battery of neuropsychological tests was administered, assessing aspects of attention, information processing speed, working memory and executive function. Sixty-five participants were recruited and 55 completed the protocol (N = 55, age: 66.8 (8.6) years, range 52–87; 15/40 female/male). Median MOCA score was 26 (IQR: 23, 27], range 15–30). No significant treatment effects were seen in any of the neuropsychological tests. There was a trend towards improved performance on Digit Span Forward (treatment effect 0.37, C.I. 0.01, 0.72; P = 0.0521). We did not identify significant treatment effects of single-administration tadalafil on neuropsychological performance in older people with SVD. The trend observed on Digit Span Forward may help to inform future studies. Clinical trial registrationhttp://www.clinicaltrials.gov. Unique identifier: NCT00123456, https://eudract.ema.europa.eu. Unique identifier: 2015–001,235–20NCT00123456.

Associação dos parâmetros clínicos de sarcopenia e comprometimento cognitivo em pessoas idosas: estudo transversal

Abstract Objective To associate clinical parameters of sarcopenia with cognitive impairment in older people. Method Cross-sectional study with 263 older adults (≥60 years) treated at a specialized public health facility. Sociodemographic and clinical variables were used to characterize the sample and the clinical parameters of sarcopenia (muscle strength, muscle mass and physical performance) were assessed based on handgrip strength (HGS), calf circumference (CC) and the Timed Up and Go (TUG) test. The Mini-Mental State Examination (MMSE) was used to evaluate cognitive status. Associations were analyzed by simple and multiple linear and logistic regression considering the clinical parameters of sarcopenia (independent variables) and cognitive status (dependent variable), adjusted for age, sex, years of schooling, number of medications, nutritional status and functional capacity. Results Of participants with cognitive impairment, 59.6% exhibited low muscle strength. Conclusion Low muscle strength was the sarcopenia parameter independently associated with cognitive impairment. This information is useful in highlighting the likelihood of cognitive impairment when poor muscle strength is identified in older people.

Association of clinical parameters of sarcopenia and cognitive impairment in older people: cross-sectional study

Resumo Objetivo Associar os parâmetros clínicos de sarcopenia com o comprometimento cognitivo em pessoas idosas. Método Estudo transversal, com 263 idosos (≥60 anos) usuários de um serviço público de atenção especializada. Variáveis sociodemográficas e clínicas caracterizaram a amostra e os parâmetros clínicos de sarcopenia (força, massa muscular e desempenho físico) foram avaliados, respectivamente, por meio da Força de Preensão Palmar (FPP), circunferência da panturrilha (CP) e o Teste Timed Up and Go (TUG). Utilizou-se o Miniexame do Estado Mental (MEEM) para avaliar o estado cognitivo. As associações foram investigadas por regressões lineares e logísticas simples e múltiplas considerando os parâmetros clínicos de sarcopenia (variáveis independentes) e o estado cognitivo (variável dependente), ajustadas para idade, sexo, anos de estudo, número de medicação, estado nutricional e capacidade funcional. Resultados Dos participantes com comprometimento cognitivo, 59,6% apresentaram baixa força muscular. O Conclusão A baixa força muscular foi o parâmetro de sarcopenia independentemente associado ao comprometimento cognitivo. Essa informação é útil para atentar-se para a probabilidade de comprometimento cognitivo quando identificada baixa força muscular em pessoas idosas.

Life-space mobility in older adults with Alzheimer's-type dementia

BackgroundMobility is an important component of functioning. Motor and cognitive impairment in older people with Alzheimer's disease can exert a negative impact on life-space mobility. ObjectiveTo compare life-space mobility in older adults with mild and moderate Alzheimer-type dementia and those without dementia and determine associations with health factors. MethodsLife-space mobility was assessed using the Life Space Assessment (LSA) in 33 older adults with Alzheimer-type dementia (AD group) and 24 older adults without dementia (WD group). The World Health Organization Disability Assessment Schedule (WHODAS 2.0), Addenbrooke's Cognitive Examination (ACE-R), Geriatric Depression Scale (GDS), Modified Baecke Questionnaire for Older Adults (MBQOA), and Short Physical Performance Battery (SPPB) were completed. Statistical analysis was performed with unpaired t-test or Mann-Whitney tests for comparisons between groups and Spearman's correlation test. ResultsThe AD group had a lower total LSA score compared to the WD group (44 vs 65, mean difference = −20.7 [95% CI: −28.6, −12.9]), 21% of the AD group were restricted to their homes when no assistance was available. In both groups, moderate correlations were found between LSA and both functioning and physical activity level. Symptoms of depression presented moderate correlation only in the WD group. ConclusionsOlder adults with AD have lower life-space mobility and require assistance to achieve higher levels of mobility. Clinical implications: LSA can help assess life-space mobility. Encouraging and enabling assistance is fundamental to a greater life-space for older adults with dementia

The drug burden index medication use in older people in north-east Nigeria

Background and Aims: Evidence has shown that physical and cognitive impairment in older people is linked with the Drug Burden Index (DBI). The study aimed to describe the prescription pattern of DBI medications, estimate the frequency of contraindicated DBI medication use, determine the rate of exposure to high-risk DBI medications, and identify the potential predictors of exposure to high-risk DBI medications.. Methods: This one-year retrospective study was conducted in a secondary healthcare facility. It included patients over 65 years of age who were prescribed at least one anticholinergic and/or sedative medication. The study data were summarized using descriptive statistics, while multivariable logistic regression analysis was used to identify potential predictors of exposure to high-risk DBI medications. Statistically, a significant level was set at p &lt; 0.05. Results: Most patients were exposed to cardiovascular drugs (57.5%) followed by antihistamines (25.8%). A total of 23 (6.3%) contraindicated DBI medications were identified. Sixty (19.6%) older patients were prescribed high-risk DBI medications. Patients over 70 years were 3.08 times significantly more likely to be exposed to high-risk DBI medications. Also, patients with a low number of non-DBI co-medications (adjusted odds ratio [AOR] 3.40, 95% CI 1.03 - 11.23), polypharmacy (AOR 7.38, 95% CI 2.20 – 24.73), and those that had contraindicated DBI medications (AOR 3.93, 95% CI 1.14 – 13.53) were significantly more likely to be exposed to high-risk DBI medications. Conclusion: The study demonstrated that most older people in the study were exposed to anticholinergic medications. A considerable proportion of these older people were exposed to contraindicated and high-risk DBI medications. Patients over 70 years of age, a low number of non-DBI co-medications, polypharmacy, and contraindicated DBI prescriptions were the significant predictors of exposure to high-risk DBI medications.

Microglial response in triggering receptor expressed on myeloid cells 2 (TREM2) knock-out mice after systemic stimulation with Escherichia coli

BackgroundSystemic infection is an important risk factor for delirium, associated with neurodegeneration and subsequent cognitive impairment in older people. Microglial cell response is a known key player in this process and we hypothesize that the triggering receptor expressed on myeloid cells 2 (TREM2) plays an important role in the regulation of this response. Methods8- to 10-week old male wild-type (WT) and TREM2 knock-out (Trem2-/-) mice were intraperitoneally inoculated with live Escherichia coli (E. coli) or saline. After inoculation, all mice were treated with ceftriaxone (an antimicrobial drug) at 12 and 24 h and were sacrificed after 2 and 3 days. Microglial response was determined by immunohistochemical staining with an ionized calcium-binding adaptor molecule 1 (Iba-1) antibody and flow cytometry. mRNA expression of pro- and anti-inflammatory mediators was measured to quantify the inflammatory response. ResultsWe observed increased Iba-1 positive cells number in thalamus of Trem2-/- mice at 3d after inoculation compared to WT mice (mean 120 cell/mm2 [SD 8] vs 105 cell/mm2 [SD 11]; p = 0.03). Flow cytometry showed no differences in forward scatter or expression of CD11b, CD45 and CD14 between WT and Trem2-/- mice. The brain mRNA expression levels of tumor necrosis factor alpha (TNF-α) of Trem2-/- mice at 2d were higher compared to WT mice (p = 0.003). Higher mRNA expression of interleukin 1 beta (IL-1β), Iba-1, CD11b and mitogen-activated protein kinase 1 (MAPK-1) was found in brain of WT mice at 2d compared to Trem2-/- mice (respectively p = 0.02; p = 0.001; p = 0.03 and p = 0.02). In spleen there were no differences in inflammatory mediators, between WT and Trem2-/- mice. InterpretationAlthough the loss of function of TREM2 during systemic infection led to an increased number of activated microglia in the thalamus, we did not observe a consistent increase in expression of inflammatory genes in the brain. The role of TREM2 in the neuro-inflammatory response following systemic infection therefore appears to be limited.

Methodologies Used to Study the Feasibility, Usability, Efficacy, and Effectiveness of Social Robots For Elderly Adults: Scoping Review.

BackgroundNew research fields to design social robots for older people are emerging. By providing support with communication and social interaction, these robots aim to increase quality of life. Because of the decline in functioning due to cognitive impairment in older people, social robots are regarded as promising, especially for people with dementia. Although study outcomes are hopeful, the quality of studies on the effectiveness of social robots for the elderly is still low due to many methodological limitations.ObjectiveWe aimed to review the methodologies used thus far in studies evaluating the feasibility, usability, efficacy, and effectiveness of social robots in clinical and social settings for elderly people, including persons with dementia.MethodsDedicated search strings were developed. Searches in MEDLINE (PubMed), Web of Science, PsycInfo, and CINAHL were performed on August 13, 2020.ResultsIn the 33 included papers, 23 different social robots were investigated for their feasibility, usability, efficacy, and effectiveness. A total of 8 (24.2%) studies included elderly persons in the community, 9 (27.3%) included long-term care facility residents, and 16 (48.5%) included people with dementia. Most of the studies had a single aim, of which 7 (21.2%) focused on efficacy and 7 (21.2%) focused on effectiveness. Moreover, forms of randomized controlled trials were the most applied designs. Feasibility and usability were often studied together in mixed methods or experimental designs and were most often studied in individual interventions. Feasibility was often assessed with the Unified Theory of the Acceptance and Use of Technology model. Efficacy and effectiveness studies used a range of psychosocial and cognitive outcome measures. However, the included studies failed to find significant improvements in quality of life, depression, and cognition.ConclusionsThis study identified several shortcomings in methodologies used to evaluate social robots, resulting in ambivalent study findings. To improve the quality of these types of studies, efficacy/effectiveness studies will benefit from appropriate randomized controlled trial designs with large sample sizes and individual intervention sessions. Experimental designs might work best for feasibility and usability studies. For each of the 3 goals (efficacy/effectiveness, feasibility, and usability) we also recommend a mixed method of data collection. Multiple interaction sessions running for at least 1 month might aid researchers in drawing significant results and prove the real long-term impact of social robots.

BRAINCODE for Cognitive Impairment Diagnosis in Older Adults: Designing a Case-Control Pilot Study.

An early, extensive, accurate, and cost-effective clinical diagnosis of neurocognitive disorders will have advantages for older people and their families, but also for the health and care systems sustainability and performance. BRAINCODE is a technology that assesses cognitive impairment in older people, differentiating normal from pathologic brain condition, based in an EEG biomarkers evaluation. This paper will address BRAINCODE’s pilot design, which intends to validate its efficacy, to provide guidelines for future studies and to allow its integration on the SHAPES platform. It is expected that BRAINCODE confirms a regular clinical diagnosis and neuropsychologic tests to discriminate ‘normal’ from pathologic cognitive decline and differentiates mild cognitive impairment from dementia in older adults with/without subjective cognitive complains.

Individual prediction and classification of cognitive impairment in patients with white matter lesions based on gray matter volume.

BackgroundVascular risk factors like white matter lesions (WMLs) are increasingly recognized as risk factors for vascular dementia (VaD) and can predict Alzheimer’s disease (AD) at least a decade before the clinical stage of the disease. This study aimed to predict cognitive decline and use machine learning techniques to classify older individuals (aged 50 years or older) with WMLs as having vascular mild cognitive impairment (VaMCI), VaD, or in good cognitive health (CH).MethodsA total of 79 individuals with WMLs were selected for this study and categorized into the following 3 groups: CH (n=25), VaMCI (n=33), and VaD (n=21). Data from the entire cohort was then divided into a training dataset (n=56) and testing dataset (n=23). The data were extracted from gray matter (GM) segmentations using voxel-based morphometry (VBM). A relevance vector regression (RVR) approach was used to test the relationship between the structural brain images and clinical scores. To predict the individual-level subtypes, we applied 2 different machine learning-based classifiers: support vector machine (SVM) and Gaussian process classification (GPC). All predictive models were trained on the training dataset and then validated on the testing dataset of age-matched participants.ResultsMulti-domain cognitive performance could be predicted based on the pattern of GM atrophy in older people with WMLs using a RVR approach. The classification of VaD versus CH (cross-validation accuracy =93.94%, test set accuracy =76.92%) and VaMCI versus CH (cross-validation accuracy =95.24%, test set accuracy =87.50%) could be successfully achieved using both SVM and GPC. However, SVM (cross-validation accuracy =67.57%, test set accuracy =70.59%) performed better than GPC in the classification of VaD versus VaMCI.ConclusionsBased on the patterns of gray matter and RVR-based model could achieve prediction of cognitive test scores, and SVM and GPC could classify the severity of cognitive impairment in older people with WMLs.

Vasculocentric Axonal NfH in Small Vessel Disease.

Cerebral small vessel disease (SVD) causes lacunar stroke and vascular cognitive impairment in older people. The pathogenic pathways from vessel pathology to parenchymal damage in SVD are unknown. Neurofilaments are axonal structural proteins. Neurofilament-light (NfL) is an emerging biomarker for neurological disease. Here, we examined the high molecular weight form neurofilament-heavy (NfH) and quantified a characteristic pattern of peri-arterial (vasculocentric) NfH labeling. Subcortical frontal and parietal white matter from young adult controls, aged controls, and older people with SVD or severe Alzheimer disease (n = 52) was immunohistochemically labeled for hyperphosphorylated NfH (pNfH). The extent of pNfH immunolabeling and the degree of vasculocentric axonal pNfH were quantified. Axonal pNfH immunolabeling was sparse in young adults but a common finding in older persons (controls, SVD, or AD). Axonal pNfH was often markedly concentrated around small penetrating arteries. This vasculocentric feature was more common in older people with SVD than in those with severe AD (p = 0.004). We conclude that axonal pNfH is a feature of subcortical white matter in aged brains. Vasculocentric axonal pNfH is a novel parenchymal lesion that is co-located with SVD arteriopathy and could be a consequence of vessel pathology.

Risk factors and association of cognitive impairment among older adults with concurrent vision and hearing impairment: A scoping study

AbstractBackgroundThe concurrent loss of vision and hearing, termed dual sensory impairment (DSI), can have a significant impact on one’s functioning. Evidence is emerging on the prevalence of DSI in the older population, including those with cognitive impairment (CI). In the context of an ageing population with increasing prevalence of DSI, we aimed to synthesize existing evidence on the association of CI with DSI and identify risk factors for the development of CI in older adults with DSI, establishing its relevance to primary prevention.MethodThe scoping review was performed using Arskey and O’Malley’s framework (2005). In June 2020, eleven scientific databases (CINAHL, Embase, Global Health, Mednar, OAIster, OpenGrey, PsycEXTRA, PsycINFO, PubMed, Web of Science, and WorldWideScience) were searched using index terms and keywords relating to CI and DSI. To be included, studies had to be empirical, peer‐reviewed, had older adults with DSI as the focal population, and have explored the concept of CI as an impairment of one or more cognitive domains, such as memory, attention, or executive functions. The screening of the retrieved studies was completed using Covidence, and relevant data were extracted using an a priori data extraction tool.ResultOut of 11,595 identified sources, 56 articles were included. Twelve studies reported the prevalence of CI in older adults with DSI, while 20 reported risk factors for CI in older adults that could be applied to older adults with DSI as well, such as depression, hearing impairment, and social isolation. Thirteen studies presented DSI alone as a risk factor for CI in older people. Seven studies reported other risk factors for CI in older adults with DSI, such as non‐sensory comorbidities, illiteracy, physical inactivity, and gender.ConclusionOur review indicates that further population‐based longitudinal research is needed to explore the association between CI and DSI and identify whether there are risk factors that are unique for CI among older adults with DSI. With the prevalence of DSI increasing in the older population, robust evidence is needed to inform the recommendations regarding screening, assessment and management of CI in older adults with DSI.

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Relationship between obesity-related anthropometric indicators and cognitive function in Chinese suburb-dwelling older adults.

BackgroundStudies relating obesity to cognition in older people show conflicting results, which may be explained by the choice of obesity indicators.ObjectivesThis study aimed to investigate the relationship between obesity-related indicators and cognitive impairment, especially between different age or gender subgroups, and explore whether obesity-related indicators were related to specific cognitive domains.MethodsThis was a cross-sectional study on 1753 participants aged ≥ 60 years (41.0% men; aged 71.36 ± 5.96 years). Obesity-related indicators included body mass index (BMI), waist circumference (WC), calf circumference (CC), waist to hip ratio (WHR), waist to calf circumstance ratio (WCR), fat to fat-free mass ratio (FM/FFM). The Mini-Mental State Examination scale (MMSE) was used to assess cognitive function. Cognitive impairment was defined as a score ≤ 17 for illiterates, ≤ 20 for participants with primary school education, and ≤ 24 for those with junior high school degrees or above. Multiple logistic regression analysis was used to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were used to analyze and visualize the linear relationships.ResultsThe prevalence of cognitive impairment was 18.77%. In the fully adjusted model, CC was negatively associated with cognitive impairment (OR = 0.94, 95% CI: 0.90−0.98). Further analysis showed that CC correlated positively with recall and place orientation. A higher FM/FFM was found to be associated with a higher prevalence of cognitive impairment (OR: 1.44, 95%CI: 0.88–2.35, P for trend = 0.029); this association was notable in women (P for trend = 0.002) and the oldest (P for trend = 0.009), and so did the potential effect of BMI on cognitive impairment (70–80 years: P for trend = 0.011; ≥ 80 years: P for trend = 0.013). No statistically significant association was found between cognitive impairment and WC, WHR, or WCR.ConclusionCC and FM/FFM were associated with cognitive impairment in older people. Future research needs to distinguish the effects of fat and muscle mass on cognitive function, with special attention to different ages and genders.

Using an E-learning activity to enhance student nurses' understanding of cognitive impairment

BackgroundNurses often lack the knowledge and expertise to work with older people with cognitive impairment, which includes dementia, delirium and depression. This is due in part to deficits in their basic nursing education related to older people and managing the care needs of people with cognitive impairment. We developed an e-learning activity to facilitate student nurses' knowledge of cognitive impairment. ObjectivesTo test if the e-learning activity could improve student nurses' knowledge of cognitive impairment and whether they would find the style of learning beneficial. DesignA quasi-experimental pre-post-test design was used to test if the cognitive impairment e-learning activity could improve student nurses' knowledge about assessing and managing the needs of older people who are experiencing cognitive impairment. A 12-item true/false quiz was completed by participants. SettingsOne large Western Canadian university. ParticipantsSecond year nursing students in the four-year baccalaureate degree program, second year nursing students in the bilingual four-year baccalaureate degree program, and first year nursing students in the two-year after-degree nursing program were invited to participate. Data from 166 students were included in the analysis (n = 166). ResultsBased on the results of a paired t-test (p < 0.001 and an average score increase of 1.12 out of nine), we conclude that students' knowledge about cognitive impairment in older people increased following the e-learning activity. Students also offered qualitative feedback that identified the activity as both helpful and as an enjoyable way to learn and provided suggestions for improvement. ConclusionsThis e-learning activity was effective in helping students learn about how to work with older people experiencing cognitive impairment. This mode of learning might be useful for other difficult-to-teach content areas.

Association between cardiometabolic risk and cognitive impairment

Several risk factors are associated with cognitive impairment in older people, but little attention has been paid to cardiometabolic variables, as well as how cognitive reserve can mediate this association. To determine the association of cardiometabolic risk factors with cognitive functioning and whether the cognitive reserve mediates this association. A cross-sectional study with 300 participants with a median age of 56 years (53% male) was conducted. Participants had a cognitive functioning assessment. Fasting glucose, HDL-cholesterol, and blood pressure were measured. A Structural Equation Modeling, revealed a direct effect of cardiometabolic latent risk factors on both a cognitive functioning (β = -.204; p = .056), and cognitive reserve factors (β = -.236, p = .04). Cognitive reserve was directly associated with cognitive functioning (β = .327, p = .01), but did not mediate the association between the cardiometabolic risk factors and cognitive functioning (β = .077, p = .07). The overall goodness of fitness was excellent χ2 (50) = 58.357, p = .195, comparative fit index = .980, Tucker-Lewis Index = .974, root mean square error of approximation = .023 and Standardized Root Mean Square Residual = .041. A direct effect of cardiometabolic risk factors on cognitive functioning was observed.

Calcium Dobesilate Reverses Cognitive Deficits and Anxiety-Like Behaviors in the D-Galactose-Induced Aging Mouse Model through Modulation of Oxidative Stress.

The long-term treatment of mice with D-galactose (D-gal) induces the overproduction of reactive oxygen species (ROS) and is a well-accepted experimental model of oxidative stress-linked cognitive disorders in physiological aging. Calcium dobesilate (CaD, Doxium®) is an established vasoactive and angioprotective drug commonly used for the clinical treatment of diabetic retinopathy and chronic venous insufficiency. It has antioxidant properties and controls vascular permeability. In the current study, we evaluated the protective effects of CaD (50 and 100 mg/kg/day p.o.) in male mice treated with D-gal (500 mg/kg/day p.o.) for six weeks. Results demonstrated that body weight loss, anxiety-like and cognitive impairments of D-gal-treated animals were reversed by CaD administration as evaluated by the measurement of mice performance in elevated plus-maze, Y-maze, and shuttle box tests. CaD treatment also inhibited the oxidative stress in aging mouse brains by decreasing malondialdehyde (MDA) levels and increasing superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) enzyme activities. These results could open new perspectives for the clinical use of CaD in treating and preventing cognitive impairment in older people.

SARS-CoV-2 Emergency and Long-Term Cognitive Impairment in Older People.

The SARS-CoV-2 infection has spread to all continents, affecting particularly older people. The complexity of SARS-CoV2 infection is still under study. Despite respiratory involvement is the main clinical manifestation of COVID-19, neurological manifestations are common. Although it is obvious to give priority to infectious emergency and the infectious disease itself, at present, however, data on potential long-term damages generally and on long-term cognitive functions impairment of older COVID-19 survivors have yet to be investigated. Because the hypothesis on the involvement of SARS-CoV-2 on the long-term cognitive decline pathogenesis would seem difficult to prove, we wanted to explore the brain mechanisms of SARS-CoV-2, in order to provide more in-depth analysis and to draw attention to a topic relevant to basic scientific research and, more generally, to the elderly population.Looking forward, we argue that an early clinical and instrumental cognitive assessment can help prevent and slow down this possible complication or at least improve the quality of life for older people Covid-19 survivor.

Do you look for information about dementia? Knowledge of cognitive impairment in older people among their relatives.

ABSTRACT.Relatives and caregivers receive little information and have poor knowledge about cognitive impairment and dementia.Objective: This study aimed to identify beliefs about cognitive impairment and aging among people who are in contact with older people with and without cognitive impairment, hypothesizing that the fact of being a close relative influences or modifies these beliefs.Methods: Seventy-eight participants were classified into two groups; group 1: relatives of patients with cognitive impairment or dementia from a behavioral neurology outpatient clinic (n1=48); and group 2: relatives of patients without objective cognitive impairment from different services of a geriatric outpatient clinic (n2=30). All subjects were asked to answer a questionnaire containing single choice and true/false questions about causes and risk factors for dementia.Results: Participants were mainly females and first-degree relatives. No statistical differences were observed for age, schooling, or follow-up time between groups. Participants recognized Alzheimer’s disease as the main cause of memory loss in older adults (group 1=34 vs. group 2=15); when asking about sources of information about cognitive impairment, the three more common answers were doctors and health professionals, Internet, and journals/books. Group 1 got higher scores on questions about causes and risk factors for dementia, but no statistical differences were found.Conclusions: Dementia literacy is low even among the people in contact with this syndrome; caring for someone with dementia changes the concepts about memory and aging but only in a small proportion. Educational strategies to deal with misinformation can help to control risk factors and reduce the incidence of dementia.