Mini-Mental State Examination Scale Scores Research Articles

Transcranial Magnetic Stimulation Combined with Auricular Point Pressure Bean on Emotional Disorders in Elderly Patients after Intracerebral Hemorrhage Surgery: A Retrospective Cohort Study.

To investigate whether the combination of repetitive transcranial magnetic stimulation (rTMS) and auricular point pressure bean could effectively ameliorate postoperative affective disorder in elderly patients suffering from cerebral hemorrhage. From June 2020 to September 2023, 116 elderly patients with depression after cerebral hemorrhage, who underwent surgical procedures were divided into the exposure group and the control group. The division was determined based on whether received rTMS and traditional Chinese medicine auricular point pressure bean therapy. Hamilton anxiety scale (HAMA), Hamilton Depression scale (HAMD), National Institutes of Health Stroke scale (NIHSS), Montreal Cognitive Assessment scale (MoCA) and Mini Mental State examination scale (MMSE) were collected and compared between before intervention and after intervention. In accordance with a 1 : 1 matching ratio, the patients in the study were paired using propensity score matching (PSM), with 53 patients in both the exposure group and the control group. There were no notable differences in baseline characteristics between the 2 groups (P > .05). Following the intervention, the HAMA score and the NIHSS score of the exposure group were markedly lower than those of the control group (P < .001). Additionally, theMoCA scores (P = .001) and MMSE scores (P < .001) in the exposure group were significantlyhigher. The difference score have a significant difference in HAMA score (P = .001), NIHSS score (P < .001), MoCA (P < .001) and MMSE scores (P < .001). The combination of rTMS therapy and auricular point pressure bean therapy in traditional Chinese medicine demonstrates can effectively relieve the anxiety level, postoperative emotional and cognitive disorders of elderly patients after intracerebral hemorrhage, and provide certain ideas and support for clinical treatment.

Effects of Dexmedetomidine on Cognitive Function, Oxidative Stress and Brain Protection in Patients Undergoing Craniocerebral Surgery

Background: The protective mechanism of dexmedetomidine on the brains of patients undergoing craniocerebral surgery remains unclear. The aim of this study was to examine the impact of dexmedetomidine on cognitive function, oxidative stress, and brain protection in such patients. Methods: Fifty-four patients who underwent craniocerebral surgery at our hospital from January 2020 to June 2023 were retrospectively selected as study subjects. They were divided into two groups: the control group (n = 27) and the study group (n = 27), based on different auxiliary anesthesia protocols. Patients in the study group received dexmedetomidine before anesthesia induction, using a midline intravenous pump to assist anesthesia, while the control group received an equivalent amount of normal saline. The remaining anesthesia induction and maintenance protocols were consistent for both groups. Cognitive function was assessed using the Mini Mental State Examination (MMSE) before and 1 day after surgery for both groups. Oxidative stress indicators, including malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) levels in the serum of both groups, were measured using enzyme-linked immunosorbent assay (ELISA). Additionally, changes in postoperative brain injury indicators, namely neuron-specific enolase (NSE) and central nervous system-specific protein (S100β), were detected and compared in the serum of both groups. Concurrently, postoperative adverse reactions were recorded for both groups. Results: The MMSE scale scores of both groups of patients 24 hours after surgery were significantly lower than those before surgery. However, the MMSE scale scores of the study group patients were notably higher than those in the control group, with a statistically significant difference (p &lt; 0.05). One hour after surgery, the serum levels of MDA, GSH-Px, and SOD in both groups of patients were significantly elevated compared to pre-surgery levels. Yet, the study group exhibited significantly lower levels of MDA, GSH-Px, and SOD in comparison to the control group, and these differences were statistically significant (p &lt; 0.05). The serum levels of NSE and S100β in both groups were markedly higher than preoperative levels 24 hours after surgery. However, the study group demonstrated significantly lower levels of serum NSE and S100β compared to the control group, with a statistically significant difference (p &lt; 0.05). The incidence of postoperative complications in the study group was 7.41% (2/27), indicating a decreasing trend compared to 18.52% (5/27) in the control group. However, this difference did not reach statistical significance (χ2 = 1.477, p = 0.224). Conclusion: Dexmedetomidine-assisted anesthesia in craniocerebral surgery can effectively enhance postoperative cognitive function, mitigate oxidative stress, and facilitate overall postoperative recovery for patients. The intervention exhibits a favorable safety profile with no reported serious adverse reactions, establishing it as a relatively safe and reliable approach.

Efficacy of Glucose Metabolism-Related Indexes on the Risk and Severity of Alzheimer's Disease: A Meta-Analysis.

Considering the strong correlation made between Alzheimer's disease (AD) and the pathology of glucose metabolism disorder, we sought to analyze the effects of fasting blood glucose (FBG) level, fasting plasma insulin (FINS) level, and insulin resistance index (HOMA-IR) on the risk and severity of AD. Reveal the pathological relationship between AD and insulin resistance. We searched 5 databases from inception through April 4, 2022. Meta-regression was conducted to identify if there were significant differences between groups. Shapiro-Wilk test and the Q-Q diagram were applied to evaluate the normality of variables. A multiple logistic regression model was employed to explore the association between FBG, FINS, HOMA-IR, and Mini-Mental State Examination scale score (MMSE). 47 qualified articles including 2,981 patients were enrolled in our study. FBG (p < 0.001), FINS (p < 0.001), and HOMA-IR (p < 0.001) were higher in AD patients than in controls. HOMA-IR was negatively correlated with MMSE (p = 0.001) and positively related to the sex ratio (male versus female) (p < 0.05). HOMA-IR obeyed lognormal distribution (p > 0.05), and the 95% bilateral boundary values were 0.73 and 10.67. FBG (p = 0.479) was positively correlated to MMSE, while FINS (p = 0.1657) was negatively correlated with MMSE. The increase in the levels of FBG, FINS, and HOMA-IR served as precise indicators of the risk of AD. HOMA-IR was found to be correlated to the increasing severity of AD, especially in male AD patients.

Association between self-reported oral health and cognitive function among the community-dwelling elderly in Jinan, China: the mediating effect of life satisfaction.

Deterioration of self-reported oral health and decline in cognitive function are two main adverse health outcomes experienced by the older adults. Little evidence was found on the psychosocial mechanism between self-reported oral health and cognitive function. This study explores the association between self-reported oral health and cognitive function and examines the mediating effect of life satisfaction among the community-dwelling elderly in Jinan, China. A total of 512 older individuals (60+) were included in the study. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination scale (MMSE), and self-reported oral health was measured using the Chinese version of the Geriatric Oral Health Assessment Index (GOHAI). Pearson correlation analysis was used to determine the relationship between self-reported oral health, life satisfaction, and cognitive function. Multivariate linear regression analysis was conducted to explore the possible effect of covariates. Structural equation modelling and Bootstrap analyses were conducted to verify the mediating role of life satisfaction. The mean MMSE score was 25.65 ± 4.42. Better self-reported oral health was significantly associated with a higher level of life satisfaction, and those with higher life satisfaction experienced better cognitive function. Age, educational level and source of living expenses were found to be cofounding variables. Life satisfaction partially mediated the effect of self-reported oral health on cognitive function (95% confidence interval [CI]: 0.010 to 0.075). The mediating effect of life satisfaction accounted for 24% of the total effect. The level of cognitive function was relatively high. Self-reported oral health was positively associated with cognitive function, and the mediating effect of life satisfaction was proven to exist in the community-dwelling older individuals. Early screening for oral diseases and a greater focus on life satisfaction are recommended.

Socio-demographic Characteristics and Cognitive Function in Adults with Type 2 Diabetes Mellitus

Introduction: Diabetes is a very common disease all over the world nowadays. Cognitive function impairment is closely related with socio-demographic characteristics of the diabetic patients. Objective: To assess the association between sociodemographic characteristics and cognitive function in adult type 2 diabetic (T2DM) patients. Materials and Methods: This cross sectional study was conducted among purposively selected 210 adult T2DM patients from July 2018 to June 2019 in two tertiary level hospital of Dhaka city. Data were collected by face to face interview using pretested semi-structured questionnaire and review of check list. Results: Mean age of the patients was 50.5 ± SD 7.4 years with male dominance (61.5%). The mean age of onset of diabetes was 41.6 ± SD 6.9. Most of the patients had normal cognitive function (71.4%) and had a mean MMSE (mini mental state examination scale) score of 25.2± SD 2.3. Statistically significant association was revealed between impaired cognitive function with age, monthly income, education, occupation, number of family members and types of residents of the respondents (p&lt;0.05). There was statistically significant negative correlation of cognitive function score with age (r = -.398, p.001) and number of family members of the respondents (r = -.429, p&lt;.001). The study also revealed a positive correlation between cognitive function score and total monthly family income of the respondents (r = .078, p&lt;.001) which was also statistically significant. Conclusion: Policy makers should take necessary measures to increase the educational and working facilities to improve the standard of life so that people can live better in a better housing condition. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 7-11

Analysis of brain perfusion single-photon emission tomography images using an easy Zscore imaging system for early diagnosis of Alzheimer's disease

To analyze single-photon emission tomography (SPECT) images of cerebral blood flow perfusion using an easy Z-score imaging system (eZIS) and explore the value of SPECT and eZIS in early diagnosis of Alzheimer's disease (AD). We retrospectively analyzed the clinical data of 71 subjects undergoing brain perfusion SPECT examination in our department from September, 2018 to September, 2020 and identified 31 eligible subjects for this study. Among these subjects, according to the NIA-AA criteria (2011 edition), 12 were diagnosed with mild cognitive impairment due to AD (MCI) and 11 with AD dementia stage (AD); 8 elderly subjects were healthy without cognitive impairment (NC). All these subjects underwent brain perfusion SPECT, and eZIS-assisted analysis was used to obtain the index values (severity, range and ratio). The differences in the severity, extent and ratio among the 3 groups were compared, and the diagnostic efficacy of single and joint analysis of the 3 indexes for early AD was analyzed. There was no significant difference in gender, age and education level among the 3 groups (P>0.05). Compared with those in NC group, the Mini Mental State Examination Scale (MMSE) scores were significantly lowered in AD group and MCI group; the MMSE score was significantly lower in AD group than in MCI group (P < 0.05). The patients with AD had significantly greater disease severity and extent than those with MCI group; the severity, range and ratio in both AD group and MCI group were significantly higher than those of NC group, but the ratio did not differ significantly between AD group and MCI group (P>0.05). In single index analysis, severity had the highest diagnostic performance (AUC=0.911) and sensitivity (87.0%); the diagnostic performance and sensitivity of joint analysis were better than those of single analysis, and joint analysis of range and ratio showed high diagnostic performance (AUC=0.948) and sensitivity (87.0%). The analysis of brain perfusion SPECT using an eZIS program can be useful for early diagnosis of AD.

Clinical Reasoning: Rapidly Progressive Thalamic Dementia

A 61-year-old White man with hypertension and diabetes presented to the emergency department with a 10-day history of excessive daytime sleepiness, confusion, mental slowing, memory loss, and behavioral changes. He had become apathetic and quieter with loss of initiative and showed reduction of spontaneous speech. No headache, fever, or recent infections were reported. Neurologic examination revealed hypomimia, mild parkinsonism (mild rigidity of the left arm, reduced bilateral arm swing during gait, global mild bradykinesia), confusion with partial disorientation in time and space, and short- and long-term memory impairment. Mini-Mental State Examination Scale score was 15. Cranial nerves, speech, language, motor, sensory, and cerebellar functions and reflexes were normal. Brain CT scan and arterial and venous CT angiography (CTA) were normal. The patient was admitted to our neurologic department for further management.

Expression of miR-28-3p in patients with Alzheimer's disease before and after treatment and its clinical value.

Expression of miR-28-3p in patients with Alzheimer's disease (AD) before and after treatment and clinical value of miR-28-3p were determined. There were three groups: 68 AD patients treated with donepezil combined with basic therapy in The People's Hospital of Shouguang collected as an AD group, 70 patients with mild cognitive impairment (MCI) as an MCI group, and 75 healthy people as a normal group. Serum miR-28-3p was detected by qRT-PCR. The Montreal cognitive assessment scale (MoCA), mini mental state examination scale (MMSE), activities of daily living scale (ADL) and homocysteine (Hcy) were adopted to assess patients before and after treatment. miR-28-3p in normal group was significantly lower than that in other two groups, and miR-28-3p in MCI group was significantly lower than that in AD group (P<0.001). miR-28-3p correlated with the course and severity of patients. miR-28-3p in AD group after treatment was significantly lower than that before treatment (P<0.001). ADL and Hcy of AD patients after treatment were significantly lower than before treatment (P<0.05), and MMSE and MoCA after treatment were significantly higher than before treatment (P<0.05). Before and after treatment, miR-28-3p was significantly positively correlated with ADL score and Hcy level, but negatively correlated with MMSE score and MoCA score. Analysis of the working characteristic curve of the patients indicated that miR-28-3p can be used for diagnosis of AD patients. Donepezil therapy may reduce miR-28-3p level to alleviate the symptoms of AD patients, and miR-28-3p level can be used as an early diagnosis and prognosis evaluation of AD patients.

Biomarkers of Alzheimer's disease in severe obstructive sleep apnea-hypopnea syndrome in the Chinese population.

Patients with severe obstructive sleep apnea-hypopnea syndrome are often accompanied by symptoms such as decreased cognitive function and daytime sleepiness, while cognitive function is often associated with biomarkers of Alzheimer's disease. Therefore, this study aims to explore the level of Alzheimer's disease biomarkers in the plasma of obstructive sleep apnea-hypopnea syndrome patients as well as the relationship between cognitive function and daytime sleepiness. Between May and July 2019, 35 patients requiring hospitalization for severe obstructive sleep apnea-hypopnea syndrome and 16 normal control patients were selected from West China Hospital. Alzheimer's disease biomarkers (Aβ40, Aβ42, t-tau, p-tau) in plasma were detected by ELISA in all 51 subjects. The differences in Alzheimer's disease biomarkers between the two groups were compared. In addition, a correlation analysis of disease-related indicators and univariate analysis of the risk factors of obstructive sleep apnea-hypopnea syndrome was conducted using the logistic regression model. The plasma levels of Alzheimer's disease biomarkers (Aβ40, t-tau, p-tau) in patients with severe obstructive sleep apnea-hypopnea syndrome were significantly higher than those in the control group (29.24 ± 32.52, 13.18 ± 10.78, p = 0.049; 11.88 ± 7.05, 7.64 ± 4.17, p = 0.037; 26.31 ± 14.41, 17.34 ± 9.12, p = 0.027). Aβ42, Aβ40, t-tau, and p-tau were significantly negatively correlated with mean oxygen saturation, low oxygen saturation and Mini-Mental State examination scale scores, and positively correlated with oxygen desaturation index and Epworth Sleepiness Scale scores. T-tau and p-tau can be used as new risk factors for obstructive sleep apnea-hypopnea syndrome. Alzheimer's disease biomarkers in the plasma of obstructive sleep apnea-hypopnea syndrome patients are higher than those in the control group, and the mechanism of action may be related to sleep disorders and night hypoxia. The Alzheimer's disease biomarkers deposited in plasma may also cause the decline of patients' cognitive function, increased daytime sleepiness and accelerate the progression of obstructive sleep apnea-hypopnea syndrome.

The efficacy of statins in the treatment of Alzheimer's disease: a meta-analysis of randomized controlled trial.

Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden, and the using of statins to treat AD has caused widely debated. The purpose of this meta-analysis is to explore the effect of statins in the treatment of Alzheimer's disease. Studies were retrieved by searching PubMed, Embase, Cochrane library, OvisdSP, Web of Science, Chinese Nation Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases before March 31, 2019. We extracted the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Neuropsychiatric Inventory (NPI), Activities of Daily Living (ADL) scale score, and other information. The pooled Weighted Mean Difference (WMD) and their 95% confidence intervals (95% CI) were calculated with random effect model or fixed random effect model. A total of nine randomized controlled trials were included that contained 1489 patients; of them, 742 patients in the statins group, 747 patients in the control group. There were nine studies used the MMSE scale, five studies used the ADAS-Cog scale, four studies used the NPI scale, and six studies used the ADL scale. Meta-analysis of the nine studies that reported the MMSE scale scores indicated that there is no significant effect of statins as compared with control group (the pooled WMD = 1.09, 95% CI, - 0.00, 2.18, p = 0.05, I2= 87.9%). Meta-analysis of the five studies that reported the ADAS-Cog scale scores also indicated that there is no significant effect of statins as compared with control group (the pooled WMD = - 0.16, 95% CI, - 2.67, 2.36, p = 0.90, I2= 80.1%). Meta-analysis of the four studies that reported the NPI scale scores indicated that treatment with statins could slow the rise in the NPI scale scores (the pooled WMD = - 1.16, 95% CI, - 1.88, - 0.44, p = 0.002, I2= 45.4%). Meta-analysis of the six studies that reported the ADL scale scores indicated that treatment with statins could improve patients' daily living ability (the pooled WMD = - 4.06, 95% CI, - 6.88, - 1.24, p = 0.005, I2= 86.7%). Results of subgroup analysis indicated that the use of statins in the short term (≤ 12months) associated with the change of the MMSE scale scores (the pooled WMD = 1.78, 95% CI, 0.53, 3.04, p = 0.005, I2= 79.6%). Sensitivity analysis and publication bias test were both negative, and the results were relatively reliable and stable. Statins used in AD patients had beneficial effects on the scores of MMSE scale in the short term (≤ 12months), and statins could slow the deterioration of neuropsychiatric status and significantly improve activities of daily living ability in AD patients, but statins did not show an advantage in the change of the ADAS-Cog scale scores.

Association between serum non-high-density lipoprotein cholesterol and cognitive dysfunction after acute ischemic stroke: a cross-sectional study.

This study aimed to explore the association between serum non-high-density lipoprotein cholesterol (non-HDL-C) and cognitive dysfunction risk in patients with acute ischemic stroke (AIS). This cross-sectional study enrolled 583 AIS patients. Biochemical markers and lipid profile were collected after admission. AIS patients were classified into high group (non-HDL-C ≥3.4 mM) and normal group (non-HDL-C <3.4 mM). Mini-Mental State Examination scale (MMSE), Montreal Cognitive Assessment scale (MoCA), Activities of Daily Living (ADL) scale, Neuropsychiatric Inventory (NPI), and Hamilton Depression scale 21 version (HAMD-21) were applied on the third day after admission. Compared with the control group, patients of the high group had higher body mass index and higher frequency of intracranial artery stenosis, and exhibited higher levels of non-HDL-C, total cholesterol, triglycerides, low-density lipoprotein cholesterol, homocysteine, fasting blood glucose, and glycosylated hemoglobin (HbA1c), and lower levels of high-density lipoprotein cholesterol (all P<0.05). Compared with the control group, patients of the high group had significantly lower MMSE and MoCA scores (MMSE: 26.01±4.17 vs 23.12±4.73, P<0.001; MoCA: 22.28±5.28 vs 20.25±5.87, P<0.001) and higher scores on the NPI and HAMD-21 (both P<0.001). MMSE (r=-0.306, P<0.001) and MoCA scores (r=-0.251, P<0.001) were negatively associated with non-HDL-C level. Multivariate regression analysis revealed that non-HDL-C level (OR=1.361, 95%CI: 1.059-1.729, P=0.016) was independently associated with the presence of cognitive dysfunction after adjusting for confounding factors. High serum non-HDL-C level might significantly increase the risk of cognitive dysfunction after AIS.

Treating Alzheimer′s disease using transcranial magnetic stimulation

Objective To observe the clinical effect of treating Alzheimer′s disease (AD) using transcranial magnetic stimulation. Methods One hundred and ninety-six patients with Alzheimer′s disease were randomly divided into an observation group and a control group, each of 98. The observation group was given transcranial magnetic stimulation of the left and right dorsolateral frontal lobes of the brain and simultaneously given 8-shaped coil stimulation. The stimulation intensity was 80% of the motor threshold with a sequence of 2 s of stimulation at 5 Hz and 30 s rest for 30 min in each session. There were two sessions a day for 28 days. The control group was treated with identical pseudo-stimulation. Moreover, both groups were treated with intravenous injections of 20 ml of Ginkgo biloba extract dissolved in 250 ml of sodium chloride, or in the control group a glucose injection, one daily for two weeks. Before and after the treatment, the cognition, behavior and neuropsychological symptoms of both groups were evaluated using the mini mental state examination scale (MMSE), the AD rating scale (ADAS-cog), the activity of daily living (ADL) scale, a neuropsychiatric questionnaire (NPI) and an AD behavioral pathology rating scale (BEHAVE-AD) to compare the clinical effects. Results There were no significant differences in the groups′ average scores on any of the evaluations before the treatment. After the treatment, the average MMSE and ADAS-cog scores in both groups had improved significantly, but with significantly greater improvement in the observation group. After the treatment, the average ADL, NPI and BEHAVE-AD scores of the observation group and the average ADL score of the control group were significantly lower than before the treatment. No significant differences were observed in the average NPI and BEHAVE-AD scores of the control group. After the intervention, the average ADL, NPI and BEHAVE-AD scores in the observation group were significantly lower than those of the control group. The total effectiveness rate of the observation group (90.8%) was significantly higher than that of the control group (62.2%). Conclusion Transcranial magnetic stimulation can significantly improve the cognitive, behavioral and neuropsychological status of patients with Alzheimer′s disease. Key words: Alzheimer′s disease; Transcranial magnetic stimulation; Ginkgo biloba extract

The mediating role of depression on the relationship between housebound status and cognitive function among the elderly in rural communities: A cross-sectional study

ObjectiveTo explore the relationship among housebound status, depression and cognitive function, and further to study whether depression can take on a mediator among elders in rural communities. MethodsA cross-sectional survey was conducted among 720 community residents aged ≥60 years from March to May in 2016 in Hebei province, China. We used the Chinese version of Housebound scale, the Rasch-Derived of the Center for Epidemiological studies Depression scale (CES-D-R), and the Minimental State Examination Scale (MMSE) to estimate housebound status, depression, and cognitive function separately. Correlation, multiple linear regression, and structural equation modeling was used to data analyses. Results712 completely replied questionnaires were finally used in the data analyses among 720 questionnaires, which indicated that effective response rate was 98.9%. Results indicated that the scores of housebound status were positively correlated with the MMSE scores. Being housebound correlated negatively with MMSE scores. Housebound status and three dimensions of CES-D-R (i.e. negative affect, positive affect, and interpersonal problems) were deemed as significant predictors of cognitive function among rural elders. The effect of housebound status on cognitive function was fully mediated by depression. ConclusionsNot all subscales of CES-D-R can affect MMSE scores among rural elders. There may be full mediation effects of depression within the impact of housebound status on cognitive function, mainly through negative affect, positive affect and interpersonal problems. It indicates that preventing the elderly from housebound status could relieve the decline of cognitive function by the intermediary role of depression.

Cognitive deficits and self-care behaviors in elderly adults with heart failure.

IntroductionElderly adults with heart failure (HF) may have problems with self-care behaviors because of cognitive deficits. Self-care deficits have been found to be significantly associated with negative health care outcomes among HF patients. The aim of this paper was to assess cognitive deficits and the level of self-care ability in elderly patients with HF, and to determine if a relationship exists between cognitive deficits and self-care.Materials and methodsThe study included 270 elderly patients (mean age: 72.5 years) with HF. We used the Mini Mental State Examination Scale (MMSE) to evaluate cognitive functioning, and the European Heart Failure Self-care Behavior Scale, revised into a nine-item scale (EHFScBS-9), to evaluate self-care behaviors. Associations between the variables were examined using multiple regression analysis.ResultsLower scores in both MMSE and EHFScBS-9 questionnaires were correlated with older age, living alone, lower education, longer duration of illness, higher number of rehospitalizations, as well as lower left ventricular ejection fraction and higher New York Heart Association (NYHA) class. The multiple regression analysis was used for evaluation of the impact of the following predictors: MMSE score, age, duration of illness, ejection fraction, number of hospitalizations, sex, residence, education, relationship status, and NYHA class on EHFScBS-9 score.ConclusionsElderly patients with HF may have worse self-care behaviors because of their cognitive deficits. Age was the strongest predictor of worse MMSE scores. Multidisciplinary health teams should pay attention to the special needs of elderly patients who live with their illness for many years and have no social support because of living alone.

The effectiveness and safety of acupuncture for patients with Alzheimer disease: a systematic review and meta-analysis of randomized controlled trials.

The use of acupuncture for treating Alzheimer disease (AD) has been increasing in frequency over recent years. As more studies are conducted on the use of acupuncture for treating AD, it is necessary to re-assess the effectiveness and safety of this practice.The objective of this study was to assess the effectiveness and safety of acupuncture for treating AD.Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, Embase, PsycINFO, Chinese Biomedicine Literature (CBM), Chinese Medical Current Content (CMCC) and China National Knowledge Infrastructure (CNKI) were searched from their inception to June 2014.Randomized controlled trials (RCTs) with AD treated by acupuncture or by acupuncture combined with 1 kind of drugs were included.Two authors extracted data independently. The continuous data were expressed as mean differences (MD) with 95% confidence intervals (CIs). Weighted MD (WMD) was used instead of standardized MD (SMD) when the same scales were used. Adverse reactions related to acupuncture were also investigated.Ten randomized controlled trials with a total of 585 participants were included in the meta-analysis. The combined results of 6 trials showed that acupuncture was better than drugs at improving scores on the Mini Mental State Examination (MMSE) scale (MD 1.05, 95% CI 0.16–1.93). Evidence from the pooled results of 3 trials showed that acupuncture plus donepezil was more effective than donepezil alone at improving the MMSE scale score (MD 2.37, 95% CI 1.53–3.21). Out of 141 clinical trials, 2 trials reported the incidence of adverse reactions related to acupuncture. Seven out of 3416 patients had adverse reactions related to acupuncture during or after treatment; the reactions were described as tolerable and not severe.Acupuncture may be more effective than drugs and may enhance the effect of drugs for treating AD in terms of improving cognitive function. Acupuncture may also be more effective than drugs at improving AD patients’ ability to carry out their daily lives. Moreover, acupuncture is safe for treating people with AD.Protocol registration: PROSPERO CRD42014009619.Protocol published in BMJ-open.

Development of successful ageing multidimensional assessment scale and its reliability and validity

Objective According to the theoretic framework of successful ageing,this study developed a multidimensional Successful Ageing Assessment Scale and tested its reliability and validity.Methods Through literature review,the study determined evaluative dimension,structure and scoring method.Then,the Successful Ageing Multidimensional Assessment Scale(SAMAS) was developed and was optimized by the expert consultation,semi-structured interview and twice tests.The predicted sample was conducted with item analysis,and testing of reliability and validity; the formal tested sample was conducted with item analysis,conformance testing and testing of reliability and validity.Then the formal tested sample was tested and retested two weeks later.The intestine emendatory Activities of Daily Living Scale (ADL),Mini Mental State Examination Scale (MMSE),Social Disability Screening Schedule (SDSS) and Memorial University of Newfoundland Scale of Happiness(MUNSH) were used to test its criteri-on validity.Results SAMAS consisted of 5 dimensions,including chronic disease state,physical perfor-mance,cognitive function,social function,subjective well-being.Item analysis showed the dimensions of scale and total scale scores had positive correlation.In conformance testing,the Kappa value was 0.65～0.86,test-retest reliability was 0.66～0.85 and the internal consistency reliability was 0.88.The correl-ative coefficient of the physical performance and social function scores were negatively correlated with ADL scores and SSDS scores,the correlative coefficient of the cognitive function and subjective well-being scores were positively correlated with MMSE scores and MUNSH scores.Conclusions SAMAS suggested good reliability,validity and could well evaluate comprehensive health for the elderly,at the same time could distinguish between SA and non SA group. Key words: Successful ageing; Multidimensional health measurement; Scale development

Effect of comprehensive nursing on cognitive and mental state and living ability of patients with Alzheimer's disease

Objective To study the effect of comprehensive nursing on the cognitive level,mental status,and the ability to live of patients with Alzheimer's disease.Methods Totals of 120 patients with Alzheimer's disease were randomly divided into two groups,each group of the 60 patients.The patients in the control group received conventional care,while the patients in the observation group were given comprehensive nursing.Then,two groups were investigated with the mini mental state examination scale (MMSE),Hamilton rating scale for depression (HAMD),Hamilton rating scale for anxiety (HAMA),and activities of daily living scale (ADL),before and after the intervention.Results No significant difference was found in the scores of patients of the MMSE,ADL,HAMA,and HAMD between two groups before the intervention (P ＞ 0.05).After the intervention,significant difference was found between control group and observation group in the MMSE score [(11.1 ±3.2) vs (23.4 ±2.7);t =22.793,P ＜0.05],ADL score[(24.1 ±4.7) vs (20.2 ± 1.3) ;t =15.251,P ＜ 0.05],HAMA score [(15.0 ± 2.1) vs (7.4 ± 1.6) ;t =22.298,P ＜ 0.05],and HAMD score [(15.8 ± 3.9) vs (7.5 ± 1.4);t =15.516,P ＜ 0.05].No significant difference was found in the change of control group before and after the intervention (P ＞ 0.05),while significant difference was found in the observation group(P ＜0.05).Conclusions The comprehensive nursing can improve the level of awareness,mental state and living ability of patients with Alzheimer's disease,and improve the patient's quality of life. Key words: Alzheimer's disease ; Nursing; Cognitive ; Mental state; Living ability

Eptastigmine led to cognitive, clinical, and functional benefits in Alzheimer's disease

Imbimbo BP, Martelli P, Troetel WM , et al, and the Eptastigmine Study Group. Efficacy and safety of eptastigmine for the treatment of patients with Alzheimer's disease. Neurology1999 Mar 10;...