Major Disorder Research Articles

Therapeutic Use of Some Common Medicinal Plants for the Treatment of Major Life Style Diseases of Chhattisgarh

About 80% of India's population receives healthcare from medicinal plants, making them extremely important. They have been used by tribes and local people for curing various diseases since the majority of disorders in today's culture are lifestyle-related. Recently, greater prominence is being laid to phyto-therapy throughout world. This study emphasises the value of therapeutic plants in the different areas of Gariyaband district of Chhattisgarh used for treating life style diseases such as asthma, diabetes, hypertension and arthritis. The research work on therapeutic plants was carried out in the years 2017 – 2018. A total of twenty-five species of plants from 17 families and 25 genera have been documented for various medicinal applications. Plant identification was done with conventional monographs and vegetation. Among 25 plant families, Fabaceae and Apocyanaceae has been obtained as dominant family and maximum 13 plant species were obtained for treating asthma disease comparatively to diabetes, arthritis and hypertension. The plants were used for medicine has enumerated alphabetically and the local name, family names, plant part used and curing diseases has documented to treat life style diseases like asthma, diabetes, hypertension and arthritis.

Suicidal Behavior in Eating Disorders

Many studies have shown that people with eating disorders have higher rates of suicidal ideation, suicide attempts, and completed suicide than the general population. One of the diseases with the highest suicide rate among psychiatric disorders is anorexia nervosa. Some hypotheses have been proposed to explain possible causes of increased suicidal behavior in eating disorders. Some conditions common to eating disorders and suicidal behavior, such as dissatisfaction with the body and interoceptive deficits, have been cited. It has been conclusively shown that psychiatric comorbidity, especially the co-diagnosis of depression, increases the risk of suicide in patients with eating disorders. However, increased suicidal behavior in eating disorders cannot be explained by comorbidity alone. The interpersonal psychological theory of suicide (IPTS), developed by Joiner, aims to understand why people commit suicide and to explain the differences in individual suicidal behavior. Some researchers have thought that the increased suicidal behavior of people with eating disorders, especially anorexia nervosa patients, is expected from the perspective of IPTS. The compensatory behaviors of patients with eating disorders, such as vomiting or chronic restrictive food intake, are painful and challenging actions for the body. It can be considered that repeated encounters with painful and challenging experiences form a habit in the individual and reduce pain avoidance. When viewed from the IPTS perspective, decreased pain avoidance may explain the increased suicide attempts and completed suicides of individuals. Clinicians working with eating disorder patients must conduct regular and comprehensive assessments of suicide. Comorbidities such as major depression, anxiety disorder, and substance-use disorder should not be overlooked in patients with eating disorders and should be taken seriously.

In silico identification and functional prediction of differentially expressed genes in South Asian populations associated with type 2 diabetes

Type 2 diabetes (T2D) is one of the major metabolic disorders in humans caused by hyperglycemia and insulin resistance syndrome. Although significant genetic effects on T2D pathogenesis are experimentally proved, the molecular mechanism of T2D in South Asian Populations (SAPs) is still limited. Hence, the current research analyzed two Gene Expression Omnibus (GEO) and 17 Genome-Wide Association Studies (GWAS) datasets associated with T2D in SAP to identify DEGs (differentially expressed genes). The identified DEGs were further analyzed to explore the molecular mechanism of T2D pathogenesis following a series of bioinformatics approaches. Following PPI (Protein-Protein Interaction), 867 potential DEGs and nine hub genes were identified that might play significant roles in T2D pathogenesis. Interestingly, CTNNB1 and RUNX2 hub genes were found to be unique for T2D pathogenesis in SAPs. Then, the GO (Gene Ontology) showed the potential biological, molecular, and cellular functions of the DEGs. The target genes also interacted with different pathways of T2D pathogenesis. In fact, 118 genes (including HNF1A and TCF7L2 hub genes) were directly associated with T2D pathogenesis. Indeed, eight key miRNAs among 2582 significantly interacted with the target genes. Even 64 genes were downregulated by 367 FDA-approved drugs. Interestingly, 11 genes showed a wide range (9–43) of drug specificity. Hence, the identified DEGs may guide to elucidate the molecular mechanism of T2D pathogenesis in SAPs. Therefore, integrating the research findings of the potential roles of DEGs and candidate drug-mediated downregulation of marker genes, future drugs or treatments could be developed to treat T2D in SAPs.

What is the place of universal, selective, and indicated prevention strategies for depression and other mood disorders?

Given the global prevalence of depression and other major mood disorders, the evidence of increasing rates among younger cohorts, the limited capacity of most treatment systems to respond to increasing demands for care, and the reality that services do not connect with a large proportion of those living with depressive disorders, a greater emphasis is being placed on our capacity to prevent the onset, recurrence, or persistence of these disabling conditions (Herrman et al., 2022).

Positron Emission Tomography Molecular Imaging of the Major Neurodegenerative Disorders: Overview and Pictorial Essay, from a Nuclear Medicine Center's Perspective.

Computed tomography (CT) and magnetic resonance imaging (MRI) provide key structural information on brain pathophysiology. Positron emission tomography (PET) measures metabolism in the living brain; it plays an important role in molecular neuroimaging and is rapidly expanding its field of application to the study of neurodegenerative diseases. Different PET radiopharmaceuticals allow in vivo characterization and quantization of biological processes at the molecular and cellular levels, from which many neurodegenerative diseases develop. In addition, hybrid imaging tools such as PET/CT and PET/MRI support the utility of PET, enabling the anatomical mapping of functional data. In this overview, we describe the most commonly used PET tracers in the diagnostic work-up of patients with Alzheimer's disease, Parkinson's disease, and other neurodegenerative diseases. We also briefly discuss the pathophysiological processes of tracer uptake in the brain, detailing their specific cellular pathways in clinical cases. This overview is limited to imaging agents already applied in human subjects, with particular emphasis on those tracers used in our department.

Eye Disease Net: an algorithmic model for rapid diagnosis of diseases.

With the development of science and technology and the improvement of the quality of life, ophthalmic diseases have become one of the major disorders that affect the quality of life of people. In view of this, we propose a new method of ophthalmic disease classification, ED-Net (Eye Disease Classification Net), which is composed of the ED_Resnet model and ED_Xception model, and we compare our ED-Net method with classical classification algorithms, transformer algorithm, more advanced image classification algorithms and ophthalmic disease classification algorithms. We propose the ED_Resnet module and ED_Xception module and reconstruct these two modules into a new image classification algorithm ED-Net, and compared them with classical classification algorithms, transformer algorithms, more advanced image classification algorithms and eye disease classification algorithms.

Wound Healing: A Brief Look at the Inflammatory Stage and Role of Medicinal Plants and Their Derivations on Modulating the Inflammatory Responses: A Systematic Review

Aims: Wound is believed to be a major disorder in certain organs and/or tissues, which could be transmitted to other tissues. Skin is constantly exposed to infections, injuries, scratches, and burns. Wound dressings are commonly utilized for the treatment of wound site and protect it from external contamination. The biological importance of natural agents, such as herbal medicines and their derivations including extracts, essential oils and active compounds in the wound healing process has attracted the attention of researchers and also some manufacturers of wound dressings. Such natural agents improve wound healing by their antioxidant and antibacterial properties. This novel review article was conducted to evaluate the effects of medicinal plants and their derivations on inflammatory responses in surgical wound infection. Methods: The data were collected from various databases using specific keywords. Results: The results revealed that different medicinal plants and their derivations decrease the inflammation in the wound healing process by modulating in gene expression of inflammatory cytokines and immune cells. Conclusion: Active compounds of medicinal plants can alleviate inflammation in the wound healing process, which must be taken into consideration in pharmaceutical industries.

Dementia subtypes, cognitive decline and survival among older adults attending a memory clinic in Cape Town, South Africa: a retrospective study

BackgroundThere are no published longitudinal studies from Africa of people with dementia seen in memory clinics. The aim of this study was to determine the proportions of the different dementia subtypes, rates of cognitive decline, and predictors of survival in patients diagnosed with dementia and seen in a memory clinic.MethodsData were collected retrospectively from clinic records of patients aged ≥ 60 seen in the memory clinic at Groote Schuur Hospital, Cape Town, South Africa over a 10-year period. Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria were used to identify patients with Major Neurocognitive Disorders (dementia). Additional diagnostic criteria were used to determine the specific subtypes of dementia. Linear regression analysis was used to determine crude rates of cognitive decline, expressed as mini-mental state examination (MMSE) points lost per year. Changes in MMSE scores were derived using mixed effects modelling to curvilinear models of cognitive change, with time as the dependent variable. Multivariable cox survival analysis was used to determine factors at baseline that predicted mortality.ResultsOf the 165 patients who met inclusion criteria, 117(70.9%) had Major Neurocognitive Disorder due to Alzheimer’s disease (AD), 24(14.6%) Vascular Neurocognitive Disorder (VND), 6(3.6%) Dementia with Lewy Bodies (DLB), 5(3%) Parkinson disease-associated dementia (PDD), 3(1.8%) fronto-temporal dementia, 4(2.4%) mixed dementia and 6(3.6%) other types of dementia. The average annual decline in MMSE points was 2.2(DLB/PDD), 2.1(AD) and 1.3(VND). Cognitive scores at baseline were significantly lower in patients with 8 compared to 13 years of education and in those with VND compared with AD. Factors associated with shorter survival included age at onset greater than 65 (HR = 1.82, 95% C.I. 1.11, 2.99, p = 0.017), lower baseline MMSE (HR = 1.05, 95% C.I. 1.01, 1.10, p = 0.029), Charlson’s comorbidity scores of 3 to 4 (HR = 1.88, 95% C.I. 1.14, 3.10, p = 0.014), scores of 5 or more (HR = 1.97, 95% C.I. 1.16, 3.34, p = 0.012) and DLB/PDD (HR = 3.07, 95% C.I. 1.50, 6.29, p = 0.002). Being female (HR = 0.59, 95% C.I.0.36, 0.95, p = 0.029) was associated with longer survival.ConclusionsKnowledge of dementia subtypes, the rate and factors affecting cognitive decline and survival outcomes will help inform decisions about patient selection for potential future therapies and for planning dementia services in resource-poor settings.

Risks of depression, anxiety, and suicide in partners of men with prostate cancer: a national cohort study.

A diagnosis of prostate cancer (PC) may cause psychosocial distress not only in a man but also in his intimate partner. However, long-term risks of depression, anxiety, or suicide in partners of men with PC are largely unknown. A national cohort study was conducted of 121 530 partners of men diagnosed with PC during 1998-2017 and 1 093 304 population-based controls in Sweden. Major depression, anxiety disorder, and suicide death were ascertained through 2018. Cox regression was used to compute hazard ratios (HRs) while adjusting for sociodemographic factors. Partners of men with high-risk PC had increased risks of major depression (adjusted HR = 1.34, 95% confidence interval [CI] = 1.30 to 1.39) and anxiety disorder (adjusted HR = 1.25, 95% CI = 1.20 to 1.30), which remained elevated 10 or more years later. Suicide death was increased in partners of men with distant metastases (adjusted HR = 2.38, 95% CI = 1.08 to 5.22) but not other high-risk PC (adjusted HR =1.14, 95% CI = 0.70 to 1.88). Among partners of men with high-risk PC, risks of major depression and anxiety disorder were highest among those 80 years of age or older (adjusted HR = 1.73; 95% CI = 1.53 to 1.96; adjusted HR = 1.70, 95% CI = 1.47 to 1.96, respectively), whereas suicide death was highest among those younger than 60 years of age (adjusted HR = 7.55, 95% CI = 2.20 to 25.89). In contrast, partners of men with low- or intermediate-risk PC had modestly or no increased risks of these outcomes. In this large cohort, partners of men with high-risk PC had increased risks of major depression and anxiety disorder, which persisted for 10 or more years. Suicide death was increased 2-fold in partners of men with distant metastases. Partners as well as men with PC need psychosocial support and close follow-up for psychosocial distress.

Is the concept of clinical staging a useful way of matching levels of intervention to the needs of young people with depressive or other mood disorders?

A clinical concept that has been taken up with some enthusiasm in mental health services for young people experiencing major mental disorders is that of clinical staging, with the emphasis on identifying and intervening in youth with various ‘at-risk’, ‘sub-threshold’ or ‘attenuated’ syndromes, before the onset of first major episodes (Shah et al 2020). While these concepts were initially developed within the rather focused context of major psychotic disorders, they are now being deployed much more widely and applied to young people presenting with a variety of mental disorders (Hickie et al 2019; Shah 2019).

Role of residential greenspace in the trajectory of major neurological disorders: A longitudinal study in UK Biobank

BackgroundStroke and dementia are major neurological disorders that contribute significantly to disease burden and are interlinked in terms of risk. Nevertheless, there is currently no study investigating the influence of residential greenspace on the trajectory of these neurological disorders. MethodsThis longitudinal study utilized data from the UK Biobank. Exposure to residential greenspace was measured by the percentage of total greenspace coverage within a 300-meter buffer zone surrounding the participants' residences. A multistate model was employed to illustrate the trajectory of major neurological disorders, and a piecewise Cox regression model was applied to explore the impact of residential greenspace on different time courses of disease transitions. ResultsWith 422,649 participants and a median follow-up period of 12.5 years, 8568 (2.0 %), 5648 (1.3 %), and 621 (0.1 %) individuals developed incident stroke, dementia, and comorbidity of both conditions, respectively. An increase in residential greenspace by one interquartile range was associated with reduced risks of transitions from baseline to stroke, dementia, and death, as well as from stroke to comorbidity. The corresponding hazard ratios (HRs) were 0.967 (95 % CI: 0.936, 0.998), 0.928 (0.892, 0.965), 0.925 (0.907, 0.942), and 0.799 (0.685, 0.933), respectively. Furthermore, the protective effect of residential greenspace on the transition from stroke or dementia to comorbidity was particularly pronounced within the first year and over 5 years after stroke and during the 2 to 3 years after dementia onset, with HRs of 0.692 (0.509, 0.941), 0.705 (0.542, 0.918), and 0.567 (0.339, 0.949), respectively. ConclusionThis study observed a protective role of residential greenspace in the trajectory of major neurological disorders and contributed to identifying critical progression windows. These findings underscore the significance of environment-health interactions in the prevention of neurological disorders.

P199: Cluster analysis dissecting cognitive deficits in older adults with major depressive disorder and the association between neurofilament light chain

Objectives:Cognitive impairment is a growing problem with increasing burden in ageing global population. Older adults with major depressive disorder (MDD) have higher risk of dementia during ageing. Neurofilament light chain (NfL) has been proven as a potential biomarker related to dementia. The present study aims to assess the cognitive deficits in older adults with MDD and investigate their association with peripheral blood levels of NfL.Design:We enrolled 39 individuals with MDD and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer’s type. Both groups were over age 65 and with restricted Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and cognitive impairment in each domain.Result:In the MDD group, participants have higher rate of family psychiatry history and higher rate of current alcohol use habit compared with patients with neurocognitive disorders. In the neurocognitive disorders group, participants showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits similar to that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster.Conclusion:We noted the negative correlation between NfL levels and cognitive performance in MDD patients whose cognitive manifestation were more similar to that of degenerative neurocognitive disorders. NfL might be a potential marker to predict patients with MDD to develop cognitive decline especially in domains typically found in Alzheimer’s disease. Further longitudinal studies are required to validate our findings for clinical implications.

Cognitive Health and Functional Abilities of Illiterate Older Peruvians

AbstractBackgroundThe demographic changes are clearly affecting developing countries like Peru. Is estimated that approximately 7% of the population in the capital city of Lima, Peru, lives with dementia but there is no knowledge of the cognitive health of illiterate older in urban and rural communities outside Lima, where 41.5% of older adults living in these communities are illiterate. On the other hand, Peru is home to tremendous social and geocultural diversity, which may mitigate the worrisome dementia risk. In this respect, it is interesting to note that many older Peruvians remain active preserved and prolonged functional independence in their respective communities for long periods of time. Additionally, in Peru, several brief cognitive tests have been validated in urban cohorts (mostly within Lima) with elementary level education, but, to our knowledge, no brief tests of cognition or functionality have been validated in illiterate Peruvians. These observations raise important research questions that the present pilot proposal seeks to begin investigating.MethodsWe are characterizing the cognitive health and functional abilities of rural and urban illiterate older adults living in two geoculturally‐distinct regions of Peru, the Andean and Amazonian regions. Within the Andes region, we are studying a cohort of illiterate older adults living in the urban area of Cuzco and another cohort from the rural area of Pomacanchis ‐ Cuzco; within the Amazon region, we will study a cohort of illiterate older adults living in the urban area of Iquitos and another cohort from the rural area of San Reyes. We are conducting a gold standard neurological, neuropsychological, and functional evaluations in all enrolled participants in each of the four cohorts and these will be used to arrive at a multidisciplinary consensus diagnosis of suspected normal aging, subjective cognitive impairment, mild neurocognitive disorder (or mild cognitive impairment), or major neurocognitive disorder (or dementia). We are correlating these diagnoses with results of brief cognitive tests and a brief functionality assessment, the MMSE, RUDAS, the BHA ‐ TabCAT, and the adapted version of PFAQ.Results In collection process ConclusionThis pilot project represents the initial steps towards addressing these hypotheses and will generate unique data.

Association of plasma biomarkers with cognitive function in persons with dementia and cognitively healthy in the Democratic Republic of Congo

AbstractBackgroundCross‐sectional and longitudinal measurements of plasma biomarkers of Alzheimer’s disease (AD) in Western countries are being applied in clinical practice, whereas their associations with culturally validated cognitive tests in other settings remain unknown. We aim to examine cross‐sectional association of plasma protein biomarker concentrations and APOE proteotype with cognitive function and explore the discriminative role of these AD biomarkers in such an association.MethodThis is a cross‐sectional retrospective study completed from 2018 to 2022 in the Democratic Republic of Congo (DRC). Subjects were recruited from clinics, hospitals, churches, and across DRC. The study started in January 2018 until December 2022. Data were analyzed from May 2022 to December 2022. The DRC Memory clinic team recruited 1430 individuals 65 years and over. Based on Community Screening Instruments for Dementia (CSID), and Alzheimer’s Questionnaire (AQ), and DSM‐5 diagnostic criteria, participants included 44 individuals classified as major neurocognitive disorder (dementia) and 41 as healthy controls (HC). Subjects underwent cognitive assessment with a validated, culturally‐tailored cognitive battery. AD plasma biomarkers (Aβ42, Aβ40, Aβ42/40, p‐tau 181), APS (derived from Aβ42/40, APOE status, and age), and APOE proteotype were utilized to assess for genetic risk.ResultIndividuals with dementia had significantly lower Aβ42/40 levels, higher APS, and higher APOE ε4 prevalence compared to HC. Linear regressions showed significantly associations between Aβ42/40 and APS with ANT, ALMT, and AVMT scores, while APOE ε4 presence was associated with ANT, ALMT, AVMT, and APT scores. APS showed the highest AUC value (AUC = 0.78, 95% CI: 0.68‐0.88) followed by Aβ42/40 (AUC = 0.75, 95% CI: 0.66‐0.86) and APOE ε4 (AUC = 0.69 (CI 0.57‐0.81) in discriminating dementia from HC.ConclusionSelect AD biomarkers were associated with cognition and differentiated dementia from HC, consistent with extant research. These findings may have implications for the assessment of AD biomarkers in DRC.

P155: Circadian Rhythms and Alzheimer's Disease

Introduction:Major neurocognitive disorder (or simply Dementia) is one of the main causes of disability and burden disease to caregivers and the health system, and a frequent cause of mortality worldwide. Alzheimer`s disease (AD) is the most common type (60-70%).AD is a progressive neurodegenerative disorder characterized by amyloid-β (Aβ) deposition, causing neuronal and synaptic loss with subsequent cognitive disfunction.There is cumulating evidence that sleep disturbances are associated with several pathological conditions, and AD is one of these. The prevalence and severity of sleep disorders is significant in AD patients, with sleep disturbances often precede its clinical diagnosis in many years. Some studies focus on possible mechanisms by which (abnormal) sleep participate in AD pathogenesis, and concluded individuals with sleep disturbances are at higher risk of developing dementia.Objectives:To highlight the current evidence on whether sleep disorders could precipitate or accelerate the clinical course of AD.Methods:Non-systematic review about sleep abnormalities and AD pathogenesis.Results:Several authors described a two-way relationship between sleep and amyloid pathology - sleep deprivation would lead to increased production and decreased clearance of Aβ; once Aβ is accumulated it results in more disrupted sleep, with an increase of Aβ production during wakefulness and a decrease of its clearance during sleep.Recent data showed that sleep continuity and architecture (decreased total sleep time, slow-wave sleep, and REM sleep) are disturbed in AD patients.Otherwise, sleep deprivation may be associated with decreased glymphatic system clearance, leading to accumulation of neurotoxic proteins, particularly Aβ (and tau). It`s also associated with proinflammatory states due to accumulation of reactive oxygen species, nucleotides and proteins during wakefulness, which leads to immune response that causes neuronal dysfunction and cellular death. Insomnia and sleep deprivation were also associated with activation of complement pathway and immunoglobulins secretion. Many studies suggest chronic sleep disruption changes blood–brain barrier structure and function leading to Aβ accumulation.Conclusions:There is emerging evidence that points sleep disturbances as both a potential marker for AD pathology and risk predictor of developing the disease. Future investigations should evaluate the relationship between specific sleep disorders and AD physiopathology.

AD8 revisited: what’s the optimal cutoff value?

AbstractBackgroundThe 8‐item Informant Interview to Differentiate Aging and Dementia (AD8) was developed as a screening tool for dementia with a cutoff of 2 suggested by the initial study. However, various studies found different cutoff values, and many suggested a cutoff of 2 might result in a high false positive rate (up to > 80%). A higher false positive rate in Taiwan was repeatedly shown when AD8 was self‐administered in local government screening programs. This study aimed to examine the performance of AD8, determine its best cutoff value, and discuss factors that may affect the performance of AD8.MethodWe recruited 119 participant‐informant dyads from a psychiatric outpatient clinic of a university medical center. For each dyad, the AD8 was administered first, and then Mini‐Mental Status Examination (MMSE) and the Clinical Dementia Rating (CDR) to minimize contamination effect. Two geriatric psychiatrists made a consensus clinical diagnosis for each subject based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) using all available clinical information, including MMSE, CDR, clinical history, other past neuropsychological tests, and neuroimaging examinations (if available).ResultThere were 37 subjects with normal cognition, 44 with mild neurocognitive disorder (mild NCD), and 28 with major neurocognitive disorder (major NCD). When the cutoff value was 2 for the differentiation between major NCD and no‐dementia subjects (including normal cognition and mild NCD), the AD8 had an AUC of 0.756, a sensitivity of 0.929, and a specificity of 0.582. But the optimal cutoff value was 4 according to the Youden index, with an AUC of 0.888, a sensitivity of 0.786, and a specificity of 0.835.ConclusionAlthough many studies recommended 2 as the best cutoff value for screening dementia, our findings and those of others suggest a cutoff of 2 may result in a high false positive rate. Many factors could affect the performance of AD8, including sample characteristics (e.g. education level), region, conduct of the test, flow of the administration (whether AD8 is administered first or contaminated by other tests), etc. Details will be discussed during the AAIC meeting.

P33: A Re-Evaluation Study and Literature Review on AD8 as a Screening Tool

Objective:The 8-Item Informant Interview to Differentiate Aging and Dementia (AD8) was developed as a screening tool for dementia with a cutoff of 2 suggested by the initial study. However, various studies found different cutoff values, and many found a cutoff of 2 might result in a high false positive rate. Furthermore, a higher false positive rate in Taiwan was repeatedly shown when AD8 was self-administered in local government screening programs. This study aimed to test the performance of AD8, define its best cutoff value, review factors that may affect its performance, and reconsider its proper role in clinical practice.Methods:We recruited 118 participant-informant dyads from a university teaching hospital. For each informant, the AD8 was administered first and then the Clinical Dementia Rating to minimize contamination effect. For each participant, two geriatric psychiatrists considered history, physical and mental status examination, laboratory testing, neuropsychological testing, and neuroimaging results to make the final consensus diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The receiver operator characteristic curve was used to assess the diagnostic performance of AD8.Results:There were 59 subjects with normal cognition, 28 with mild neurocognitive disorder, and 31 with major neurocognitive disorder or dementia. To discriminate between dementia and non- dementia, a cutoff of 2 resulted in a sensitivity of 0.903, specificity of 0.598, and area under the curve (AUC) of 0.751. Moving the cutoff to 3 and 4 led to better specificity (0.7126, 0.8621) and greater AUC (0.776, 0.818), albeit some loss in sensitivity (0.8387, 0.7742). The best cutoff score was 4 based on the Youden index. Without considering the mild cognitive impairment group, the optimal cutoff remained at 4, with equal sensitivity and even higher specificity.Conclusion:Our findings suggest the AD8 may perform better and have a lower false positive rate with a cutoff value higher than 2. A literature review found its performance could be affected by disease prevalence across various healthcare settings, education level, regions, respondents’ personality and understanding of questions, conduct of test, flow of test administration, etc. We will discuss the details and best screening strategies at the IPA Congress.

White matter hyperintensity volume changes are associated with progressive hippocampal atrophy in Insight 46: the neuroscience sub‐study of the MRC National Survey of Health and Development, the British 1946 birth cohort

AbstractBackgroundWhite matter hyperintensity volume (WMHV) is a presumed marker of cerebrovascular disease associated with ageing, Alzheimer’s disease (AD) and vascular dementia. Higher baseline WMHV is associated with increased brain atrophy rate, with disproportionate effects in the hippocampus – a region affected early in AD. Understanding the relationships between longitudinal change in WMHV and hippocampal atrophy, while accounting for AD and cardiovascular risk factors, will increase our understanding of the multifactorial disease processes occurring during the early stages of AD.MethodRate of change in WMHV was calculated using Bayesian Model Selection (BaMoS) and total hippocampal atrophy rate was calculated using the Boundary Shift Integral (BSI), measured concurrently between two time‐points. Participants with major neurological disorders were excluded. Linear regression was used to test whether rates of WMHV change predicted rates of hippocampal atrophy while adjusting for total intracranial volume (TIV), sex and age. Further models adjusted for baseline PET amyloid‐β (Aβ) standard uptake value ratio (SUVR), ApoE‐e4 carrier status, and Framingham heart study cardiovascular risk (FHS‐CVS) aged 69, and tested for interactions with rate of WMHV change.Result308 individuals with high‐resolution isotropic MRI data at two time‐points were analysed in this study (Table 1). For every 1ml/year increase in WMHV there was an associated 0.013ml/year decrease in total hippocampal volume (Table 2, Model 1). This association remained when adjusting for Aβ SUVR (Table 2, Model 2), ApoE‐e4 status (Table 2, Model 3), and FHS‐CVS (Table 2, Model 4). A separate semi‐partial correlation analysis showed 4.6% of variance in rate of hippocampal atrophy was uniquely explained by rate of WMHV change when accounting for TIV, sex and age. There were no significant interactions between rate of WMHV change and Aβ, ApoE‐e4 or FHS‐CVS in relation to hippocampal atrophy rate.ConclusionIncreases in WMHV were significantly associated with progressive hippocampal atrophy accounting for head size, age and sex. These associations were not materially changed when adjusting for amyloid deposition, ApoE‐e4 or cardiovascular risk factors. These results suggest systemic processes that contribute to WMH development also contribute to hippocampal atrophy. Further work is required to determine the processes that drive this relationship.

Технология микрохирургической реконструкции фовеа при макулярных разрывах

Macular rupture is among major vitreoretinal disorders resulting in significant visual function decline. In recent years, the use of platelet-rich autoplasma in the macular rupture surgery is considered to be promising. However, despite high rate of macular rupture closure (78–96%), the development of new technology for foveal microarchitectonics restoration and visual function improvement currently remains a pressing issue. The study was aimed to develop a new foveal reconstruction technique for macular rupture involving the use of autologous conditioned plasma. The reported study involved 9 patients (10 eyes) with idiopathic macular hole, who underwent standard three-port 27G vitrectomy involving the use of autologous conditioned plasma in accordance with the technique developed. The proposed technique makes it possible to achieve good clinical and functional surgical treatment outcome and ensures optimal and more manageable reconstruction of foveal microarchitectonics.

P194: A comparison study between AD8 and modified AD8 for dementia screening

Objective:The 8-item Informant Interview to Differentiate Aging and Dementia (AD8) was developed as a screening tool for dementia with a cutoff of 2 suggested by the initial study. However, various studies found different cutoff values, and many suggested a cutoff of 2 might result in a high false positive rate. A higher false positive rate in Taiwan was repeatedly shown when AD8 was self-administered in local government screening programs. We have developed a modified version of AD8 (m-AD8) with the purpose of enhancing its specificity. This study aimed to compare the performance of AD8 and m-AD8.Methods:The m-AD8 consists of all items adapted from the original AD8. Modifications included: (1) limiting the evaluated period to the past year instead of the past several years, (2) reselecting examples to reflect the socio-cultural context in Taiwan, and (3) rearranging the order of questions according to their complexity. We recruited 118 participant-informant dyads from a university teaching hospital. For each informant, the AD8 was administered first and then the Clinical Dementia Rating (CDR) to minimize contamination effect. The m-AD8 was administered 7 days later. Two geriatric psychiatrists made the final consensus DSM-5 diagnosis for each subject after considering all clinical information, including history, Mini-Mental State Examination (MMSE), CDR, and, if available, other past neuropsychological tests and neuroimaging.Results:There were 59 subjects with normal cognition, 28 with mild neurocognitive disorder, and 31 with dementia (major neurocognitive disorder). When comparing dementia vs. non-dementia, the optimal cutoff value was 4 for both versions according to the Youden index. The AUC, sensitivity, and specificity were 0.893, 0.774, 0.862 for AD8, and 0.883, 0.741, 0.954 for m-AD8, respectively. The m-AD8 showed improved specificity, which was also true when the cutoff value was set as 2 or 3.Conclusion:The optimal cutoff value for both versions was 4. The modification may change the performance of AD8 with improved specificity. These findings suggest that, depending on different situations, AD8 with a cutoff value higher than 2 may perform better in dementia screening.