Elderly Mild Cognitive Impairment Patients Research Articles

Study On the Impact of Hand Exercise on The Cognitive Function of The Elderly Brain

This study aims to evaluate the impact of unarmed strength training on the cognitive function of middle-aged and elderly patients with mild cognitive impairment (MCI). The study subjects are 60 elderly male MCI patients from the Community Health Service Center in Hangzhou, with an age range of 66±5 years. The participants were randomly divided into two groups: the control group and the intervention group. The control group did not receive any intervention measures, while the intervention group underwent a 12-week unarmed strength training program. Before and after the study, the Montreal Cognitive Assessment Scale (MoCA) was used to assess the changes in cognitive function of the subjects. The data analysis was conducted using SPSS 23.0 software, and t-tests and chi-square tests were used for inter-group comparisons based on the distribution characteristics of the data. After 12 weeks of unarmed training, the MoCA score of the intervention group at T2 was significantly higher than that of the control group (P<0.05), indicating that the cognitive function of the intervention group had significantly improved. Unarmed strength training has a positive impact on the cognitive function of middle-aged and elderly MCI patients, and a 12-week training program can effectively improve the cognitive ability of this group.

Cognitive training based on functional near-infrared spectroscopy neurofeedback for the elderly with mild cognitive impairment: a preliminary study.

Mild cognitive impairment (MCI) is often described as an intermediate stage of the normal cognitive decline associated with aging and dementia. There is a growing interest in various non-pharmacological interventions for MCI to delay the onset and inhibit the progressive deterioration of daily life functions. Previous studies suggest that cognitive training (CT) contributes to the restoration of working memory and that the brain-computer-interface technique can be applied to elicit a more effective treatment response. However, these techniques have certain limitations. Thus, in this preliminary study, we applied the neurofeedback paradigm during CT to increase the working memory function of patients with MCI. Near-infrared spectroscopy (NIRS) was used to provide neurofeedback by measuring the changes in oxygenated hemoglobin in the prefrontal cortex. Thirteen elderly MCI patients who received CT-neurofeedback sessions four times on the left dorsolateral prefrontal cortex (dlPFC) once a week were recruited as participants. Compared with pre-intervention, the activity of the targeted brain region increased when the participants first engaged in the training; after 4 weeks of training, oxygen saturation was significantly decreased in the left dlPFC. The participants demonstrated significantly improved working memory compared with pre-intervention and decreased activity significantly correlated with improved cognitive performance. Our results suggest that the applications for evaluating brain-computer interfaces can aid in elucidation of the subjective mental workload that may create additional or decreased task workloads due to CT.

Abnormal Functional Hierarchies of EEG Networks in Familial and Sporadic Prodromal Alzheimer's Disease During Visual Short-Term Memory Binding.

Alzheimer's Disease (AD) shows both complex alterations of functional dependencies between brain regions and a decreased ability to perform Visual Short-Term Memory Binding (VSTMB) tasks. Recent advances in network neuroscience toward understanding the complexity of hierarchical brain function here enables us to establish a link between these two phenomena. Here, we study data on two types of dementia at Mild Cognitive Impairment (MCI) stage-familial AD patients (E280A mutation of the presenilin-1 gene) and elderly MCI patients at high risk of sporadic AD, both with age-matched controls. We analyzed Electroencephalogram (EEG) signals recorded during the performance of Visual Short-Term Memory (VSTM) tasks by these participants. Functional connectivity was computed using the phase-lag index in Alpha and Beta; and network analysis was employed using network indices of hierarchical spread (degree variance) and complexity. Hierarchical characteristics of EEG functional connectivity networks revealed abnormal patterns in familial MCI VSTMB function and sporadic MCI VSTMB function. The middle-aged familial MCI binding network displayed a larger degree variance in lower Beta compared to healthy controls (p = 0.0051, Cohen's d = 1.0124), while the elderly sporadic MCI binding network displayed greater hierarchical complexity in Alpha (p = 0.0140, Cohen's d = 1.1627). Characteristics in healthy aging were not shown to differ. These results indicate that activity in MCI exhibits cross-frequency network reorganization characterized by increased heterogeneity of node roles in the functional hierarchy. Aging itself is not found to cause VSTM functional hierarchy differences.

Depression symptoms moderate the relationship between gray matter volumes and cognitive function in patients with mild cognitive impairment

Previous studies have demonstrated that decreased gray matter volume (GMV) correlates with cognitive function in elderly patients with mild cognitive impairment (MCI). However, it is unclear whether those correlations are present in MCI patients with depressive symptoms (MCID). This study investigated the association among depressive symptoms, GMV and cognitive function. We included 210 participants, namely, 70 elderly MCID patients, 70 MCI patients without depressive symptoms (MCIND) and 70 healthy controls (HCs). Voxel-based morphometry (VBM) was used to investigate the structural disruptions among the patients in the three groups, and correlation analysis was performed between the GMV of regions showing group differences and cognitive function. Moderation analyses were conducted to verify the conditional effect of depressive symptoms on the relationship between structural changes and cognitive function. We found decreased GMV in the bilateral fusiform gyrus, inferior temporal gyrus, parahippocampal gyrus, and hippocampus in the MCIND group compared to the HC group. Moreover, we identified decreased GMV in the bilateral fusiform gyrus in the elderly MCID patients compared with the elderly MCIND patients, which provides further insights into the neural mechanisms of depressive symptoms in patients with MCID. Most importantly, the severity of depressive symptoms moderated the positive correlation between the GMV of abnormal brain regions and cognitive function. Furthermore, this study is the first report of the moderating effect of depressive symptoms on the GMV of abnormal brain areas and cognitive function in patients with MCID, indicating the significance of clinical intervention in elderly MCI patients with depressive symptoms.

The application value of plasma heterogeneous nuclear ribonucleoprotein A2/B1, Aβ42 and P-tau in the preoperative diagnosis of mild cognitive dysfunction

Objective: To explore the application value of plasma heterogeneous nuclear ribonucleoprotein A2/B1(hnRNP A2B1), β-amyloid 42(Aβ42) and phosphorylated tau protein(P-tau) levels in elderly patients in the preoperative diagnosis of mild cognitive impairment(MCI). Methods: A total of 200 patients who underwent elective surgery at Tianjin Third Central Hospital from June 2020 to March 2021were Enrolled, regardless of gender, age 65-80 years old. According to the international MCI working group standards and the European Alzheimer's Disease Federation working group standards, patients were divided into MCI group and control group. There were 58 males and 42 females in each group. The patient's plasma hnRNP A2/B1, Aβ42 and P-tau levels were detected before operation. The sensitivity, specificity and accuracy of the diagnosis of MCI were calculated. The receiver operating characteristic curve were drew to evaluate the diagnostic value of each index. Results: The plasma levels of hnRNP A2/B1, Aβ42 and P-tau in the MCI group were 310.0 (275.1, 344.2), 34.5 (24.9, 42.5), 190.4 (150.4, 301.7) ng/L, respectively, which were significantly higher than those of the control group [272.7 (239.6, 291.5), 18.7 (14.7, 26.6), 140.0 (101.8, 217.5) ng/L]. The differences were statistically significant (all P<0.05). Taking the international MCI working group standard as the gold standard, the sensitivity, specificity and area under the ROC curve (AUC) of plasma hnRNP A2/B1 for predicting MCI were 80%, 61%, and 0.781, respectively. The sensitivity, specificity and AUC of plasma Aβ42 for predicting MCI were 78%, 73%, and 0.744. The sensitivity, specificity, and AUC of P-tau for predicting MCI were 51%, 79%, and 0.675, respectively. The sensitivity, specificity and AUC of hnRNP A2/B1 and Aβ42 in predicting MCI were not statistically significant (all P>0.05), but the sensitivity of both were higher than P-tau (all P<0.001). Compared with P-tau, the AUC of plasma hnRNP A2/B1 was higher when predicting MCI (P<0.05). When the three indicators were combined, the sensitivity was 82%, and the AUC was 0.842, both of which were the highest, but the specificity reduced (71%) (all P<0.05). Conclusions: Plasma hnRNP A2/B1 combined with Aβ42 and P-tau levels can improve the sensitivity and accuracy of MCI diagnosis in elderly MCI patients before surgery, and have the greatest diagnostic efficiency. It has certain application value.

Association Analysis of Polymorphisms in BIN1, MC1R, STARD6 and PVRL2 with Mild Cognitive Impairment in Elderly Carrying APOE ε4 Allele.

BackgroundApolipoprotein (APOE) ε4 is recognized as an independent risk factor for mild cognitive impairment (MCI). However, not everyone with the ε4 allele develops MCI, suggesting that other susceptibility genes exist. This study aimed to identify MCI susceptibility genes, including BIN1, MC1R, STARD6, and PVRL2, in elderly Han Chinese and to verify their association with APOE ε4 allele in MCI onset.MethodsTo determine whether polymorphisms in BIN1 (rs6733839, rs7561528), MC1R (rs2228479), STARD6 (rs10164112), and PVRL2 (rs6859) occurred in elderly MCI patients carrying APOE ε4 allele, we carried out a case–control study including 285 MCI patients and 326 healthy controls.ResultsStatistically significant differences in the proportion of APOE ε4 carriers, and BESCI, ADAS-cog, and CNT scores existed between the NC and MCI groups (all P < 0.01). Frequencies of the rs10164112 T and rs6859 A alleles were significantly higher in the latter than in the former (P = 0.01; 0.029). However, no significant differences in allele and genotype distribution of BIN1 (rs6733839, rs7561528) and MC1R (rs2228479) existed between samples in our two groups (all P > 0.05). When stratified by APOE ε4 status (carriers/non-carriers), genotype frequencies of BIN1 rs7561528, STARD6 rs10164112, and PVRL2 rs6859 among the four groups (NCε4+, NCε4-, MCIε4+, MCIε4-) were significantly different. Additionally, our results suggest a significant association between MCI and BIN1 rs7561528, STARD6 rs10164112, and PVRL2 rs6859 (all P<0.05) in elderly carriers.ConclusionThis suggests that among the Han Chinese, MCI in elderly APOE ε4 carriers may be related to the BIN1 (rs7561528), STARD6 (rs10164112) and PVRL2 (rs6859). Genotype AA of rs7561528 and TT of rs10164112 might be protective factors against MCI in elderly APOE ε4 carriers.

The comparative effectiveness of traditional Chinese medicine exercise therapies in elderly people with mild cognitive impairment: A protocol for a network meta-analysis.

Background:Mild cognitive impairment (MCI) in the elderly is a health problem worldwide. Several clinical trials indicated that traditional Chinese medicine (TCM) exercise therapies can effectively improve MCI, such as Tai Ji, Baduan jin exercise, Liuzi jue, and finger exercise. However, there is still controversy over which therapy is the best for elderly MCI patients. In this study, we aimed to systematically evaluate and compare the effectiveness and safety of these 4 TCM exercise therapies in elderly patients with MCI.Methods:The Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure, Wangfang database, and Chinese Biomedical Medicine will be comprehensively searched to collect all randomized controlled trials which included elderly participants with MCI receiving TCM exercise therapies through July 2020. Two reviewers will independently screen and evaluate each included study and extract the outcome indexes. ADDIS 1.16.8 software will be used for the network meta-analysis and STATA 14 software will be used for drawing network evidence plots and funnel plots.Results:We will use the Bayesian statistical model to conduct a network meta-analysis to rank the effectiveness and safety of these 4 interventions, and use the GRADE approach to interpret the results.Conclusion:This network meta-analysis will find out the optimal treatment plan for MCI and provide evidence-based bias for clinical treatments decision-making.Protocol registration number:INPLASY202070006.

Effects of Acupuncture Therapy on MCI Patients Using Functional Near-Infrared Spectroscopy.

Acupuncture therapy (AT) is a non-pharmacological method of treatment that has been applied to various neurological diseases. However, studies on its longitudinal effect on the neural mechanisms of patients with mild cognitive impairment (MCI) for treatment purposes are still lacking in the literature. In this clinical study, we assess the longitudinal effects of ATs on MCI patients using two methods: (i) Montreal Cognitive Assessment test (MoCA-K, Korean version), and (ii) the hemodynamic response (HR) analyses using functional near-infrared spectroscopy (fNIRS). fNIRS signals of a working memory (WM) task were acquired from the prefrontal cortex. Twelve elderly MCI patients and 12 healthy people were recruited as target and healthy control (HC) groups, respectively. Each group went through an fNIRS scanning procedure three times: The initial data were obtained without any ATs, and subsequently a total of 24 AT sessions were conducted for MCI patients (i.e., MCI-0: the data prior to ATs, MCI-1: after 12 sessions of ATs for 6 weeks, MCI-2: another 12 sessions of ATs for 6 weeks). The mean HR responses of all MCI-0–2 cases were lower than those of HCs. To compare the effects of AT on MCI patients, MoCA-K results, temporal HR data, and spatial activation patterns (i.e., t-maps) were examined. In addition, analyses of functional connectivity (FC) and graph theory upon WM tasks were conducted. With ATs, (i) the averaged MoCA-K test scores were improved (MCI-1, p = 0.002; MCI-2, p = 2.9e–4); (ii) the mean HR response of WM tasks was increased (p < 0.001); and (iii) the t-maps of MCI-1 and MCI-2 were enhanced. Furthermore, an increased FC in the prefrontal cortex in both MCI-1/MCI-2 cases in comparison to MCI-0 was obtained (p < 0.01), and an increasing trend in the graph theory parameters was observed. All these findings reveal that ATs have a positive impact on improving the cognitive function of MCI patients. In conclusion, ATs can be used as a therapeutic tool for MCI patients as a non-pharmacological method (Clinical trial registration number: KCT 0002451 https://cris.nih.go.kr/cris/en/).

Blueberry Extracts Supplementation Improves Cognitive Function in Elderly Patients with Mild Cognitive Impairment (P14-013-19)

ObjectivesAn intervention study was performed to determine if supplement containing blueberry extracts could improve cognitive function in the elderly patients with mild cognitive impairment (MCI). MethodsForty six MCI patients participated in the intervention study were paired based on their age, education level and initial the basic cognitive aptitude test (BCAT) scores and then randomly assigned to the intervention group (n = 23, which received 1.0 g/day of blueberry extracts) or blank control group (n = 23). The endpoint was the improvement in cognitive function as evaluated by BCATs. All parameters were measured before and after the treatment period of 12 weeks. ResultsAfter 12 weeks of intervention, we observed significant improvement in their total BCAT score, space imagery efficiency, working memory and recognition memory of subjects in patients with blueberry extracts supplementation comparing to those in the control group (P = 0.006, 0.023, 0.000, 0.005, respectively). However the levels of inflammatory factors (IL-6 and TNF-α in serum) showed no significant changes after intervention. ConclusionsThe data indicated that blueberry has a beneficial effect on cognitive function of the elderly MCI patients, which might provide therapeutic potential for Alzheimer’s disease. Funding SourcesThis work was supported by the State Key Program of National Natural Science Foundation of China and the State Key Program of National Natural Science Foundation of Tianjin. Supporting Tables, Images and/or Graphs▪▪▪▪▪

Depression of community elderly patients with mild cognitive impairment and its influencing factors

Objective To investigate the depression of community elderly patients with mild cognitive impairment (MCI) and to analyze its influencing factors so as to provide a basis for relieving the depression and delaying the conversion of MCI among elderly patients to dementia. Methods From December 2016 to March 2018, we selected 1 093 community elderly people (≥60 years old) complained of cognition hypofunction by convenience sampling. All of the aged were investigated with the general information questionnaire, Peking Union Medical College Hospital Version of Montreal Cognitive Assessment (MoCA-P) and Activities of Daily Living (ADL) . Outpatient doctors of neurology department at a ClassⅢ Grade A hospital in Beijing provided clinical diagnosis for elderly patients with primary screening of MCI. The Geriatric Depression Scale-30 (GDS-30) was used to assess depression of MCI patients. SPSS 21.0 was used to the date entry and statistical analysis, and multiple Logistic regression was used to analyze the influencing factors of depression. Results A total of 271 community elderly people were diagnosed as MCI. After excluding 30 depression assessment questionnaires with glaring holes and regularity, a total of 241 valid questionnaires were collected finally with 88.93% for the effective rate. Among 241 community elderly patients with MCI, 71 cases of them were with depression and the incidence was 29.46%; the score of depression was (15.99±4.31) ; a total of 59 cases (83.10%) of them had the moderate depression and 12 cases (16.90%) had severe depression. Multiple Logistic regression analysis showed that the risk factors of depression included insomnia (OR=2.09) , negative emotions such as anxiety or agitation (OR=6.25) , recent major events (OR=3.93) and poor ADL (OR=1.45) , the protective factors of depression included ages of over 80 years (OR=0.29) compared with the ages from 60 to 65 years among elderly MCI patients. Conclusions The incidence of elderly MCI patients with depression is high. Based on comprehensive evaluation for elderly MCI patients, nurses should pay attention to their depression emotions and help patients to improve sleep and ADL, and help them positively deal with negative influences brought by major events. Key words: Aged; Mild cognitive dysfunction; Depression; Cognition; Activity of daily living; Influencing factors

Assessment of impairment in activities of daily living in mild cognitive impairment using an individualized scale.

Mild impairment in activities of daily living (ADL) can occur in Mild Cognitive Impairment (MCI), but the nature and extent of these difficulties need to be further explored. The Canadian occupational performance measure (COPM) is one of the few individualized scales designed to identify self-perceived difficulties in ADL. The present study investigated impairments in ADL using the COPM in elderly with MCI. A total of 58 MCI patients were submitted to the COPM for studies of its validity and reliability. The COPM proved a valid and consistent instrument for evaluating ADL in elderly MCI patients. A total of 74.6% of the MCI patients reported difficulties in ADL. Of these problems, 41.2% involved self-care, 31.4% productivity and 27.4% leisure. This data further corroborates recent reports of possible functional impairment in complex ADL in MCI.

Increased biomagnetic activity in the ventral pathway in mild cognitive impairment

Objective Mild cognitive impairment (MCI) patients represent an intermediary state between healthy aging and dementia. MCI activation profiles, recorded during a memory task, have been studied either through high spatial resolution or high temporal resolution techniques. However, little is known about the benefit of combining both dimensions. Here, we investigate, by means of magnetoencephalography (MEG), whether spatio-temporal profiles of neuromagnetic activity could differentiate between MCI and age-matched elderly participants. Methods Taking the advantage of the high temporal resolution and good spatial resolution of MEG, neuromagnetic activity from 15 elderly MCI patients and 20 age-matched controls was recorded during the performance of a modified version of the Sternberg paradigm. Results Behavioral performance was similar in both groups. A between group analysis revealed that MCI patients showed bilateral higher activity in the ventral pathway, in both the target and the non-target stimuli. A within-group analysis of the target stimuli, indicates a lack of asymmetry through all late latency windows in both groups. Conclusions MCI patients showed a compensatory mechanism represented by an increased bilateral activity of the ventral pathway in order to achieve a behavioral performance similar to the control group. Significance This spatio-temporal pattern of activity could be another tool to differentiate between healthy aging and MCI patients.

Challenging the cholinergic system in mild cognitive impairment: a pharmacological fMRI study

Mild cognitive impairment (MCI) often represents an early form of Alzheimer disease (AD). In both MCI and AD, characteristic cholinergic changes may occur. Functional magnetic resonance imaging (fMRI) may help to examine neurochemical changes in early disease by studying signal reactivity to pharmacological challenge. In this study, MCI patients [n=28; mean age 73.6+/-7.5; mini mental state examination (MMSE) 27.0+/-1.2] were scanned during task performance in a randomized trial under three different medication regimes: at baseline [BL; no galantamine (GAL)], after a single oral dose of GAL (SD), and after prolonged exposure (steady state: SS). Memory tasks included an episodic face-encoding task and a parametric n-letter back working memory (WM) task. Alterations in brain activation patterns before and after treatment were analyzed for both tasks using multilevel statistical analysis. Significant increases in brain activation from BL were observed after prolonged exposure only. For face encoding (n=28), these involved left prefrontal areas, the anterior cingulate gyrus, left occipital areas, and left posterior hippocampus. For working memory (n=28), increased activation was found in right precuneus and right middle frontal gyrus, coinciding with increased accuracy scores after GAL treatment. In conclusion, cholinergic challenge produces alterations in brain activation patterns in elderly MCI patients that can be detected with fMRI. This should encourage further functional imaging studies to examine the status of neurotransmitter systems in disease.