Mini-Mental State Examination Test Research Articles

Virtual Reality and Exercise Training Enhance Brain, Cognitive, and Physical Health in Older Adults with Mild Cognitive Impairment.

We investigated the effectiveness of virtual-reality-based cognitive training (VRCT) and exercise on the brain, cognitive, physical and activity of older adults with mild cognitive impairment (MCI). Methods: This study included 99 participants (70.8 ± 5.4) with MCI in the VRCT, exercise, and control groups. The VRCT consisted of a series of games targeting different brain functions such as executive function, memory, and attention. Twenty-four sessions of VRCT (three days/week) were performed, and each session was 100 min long. Exercise intervention consisted of aerobic and resistance trainings performed in 24 sessions for 60 min (2 times/week for 12 weeks). Global cognitive function was measured using the Mini-Mental State Examination (MMSE) test. Resting-state electroencephalography (EEG) of the neural oscillatory activity in different frequency bands was performed. Physical function was measured using handgrip strength (HGS) and gait speed. Results: After the intervention period, VRCT significantly improved the MMSE scores (p < 0.05), and the exercise group had significantly improved HGS and MMSE scores (p < 0.05) compared to baseline. One-way analysis of variance (ANOVA) of resting-state EEG showed a decreased theta/beta power ratio (TBR) (p < 0.05) in the central region of the brain in the exercise group compared to the control group. Although not statistically significant, the VRCT group also showed a decreased TBR compared to the control group. The analysis of covariance (ANCOVA) test showed a significant decrease in theta band power in the VRCT group compared to the exercise group and a decrease in delta/alpha ratio in the exercise group compared to the VRCT group. Conclusion: Our findings suggest that VRCT and exercise training enhances brain, cognitive, and physical health in older adults with MCI. Further studies with a larger population sample to identify the effect of VRCT in combination with exercise training are required to yield peak benefits for patients with MCI.

A Retrospective Study on Clinical Assessment of Cognitive Impairment in a Swedish Cohort: Is There Inequality Between Natives and Foreign-Born?

People with a migration background are underrepresented in dementia research and disfavored in assessment and treatment, and many foreign-born individuals with dementia remain undiagnosed. The aim of this study was to examine whether there is inequality in the clinical assessment of dementia between native and foreign-born individuals in Sweden. Information was gathered retrospectively from a cohort of 91 native and 36 foreign-born patients attending four memory clinics in Skåne, Sweden. Data included information on cognitive test results, cerebrospinal fluid biomarkers, scores at structural imaging scales of global cortical atrophy (GCA), medial temporal lobe atrophy (MTA) and the Fazekas scale, laboratory measures of thyroid-stimulating hormone, calcium, albumin, homocysteine, hemoglobin, cobalamin (vitamin B12), and folate (vitamin B9), contact with health care, and treatment. Foreign-born patients had lower educational level and scored lower on Mini-Mental State Examination and Clock Drawing Test (p &lt; 0.001-0.011). Relatives initiated contact with health care to a higher extent in the foreign-born group (p = 0.031). Foreign-born patients had less white matter lesions (p = 0.018). Additionally, Alzheimer's disease (AD) biomarkers were significantly less used in foreign-born patients to support an AD diagnosis (p = 0.001). No significant differences were found for scores on GCA and MTA, laboratory measures, or initiated treatment. Although native and foreign-born patients were predominantly homogenous regarding examined variables, differences in the diagnostic process and underlying biological correlates of dementia exist and need to be further investigated in a larger sample.

Effect of transcranial magnetic stimulation in combination with citalopram on patients with post-stroke depression.

BackgroundAmelioration of depression in patients with post-stroke depression (PSD) remains challenging.ObjectiveThe primary vision was to explore the effect of transcranial magnetic stimulation (TMS) in combination with citalopram on patients with PSD.MethodsOne hundred eligible patients who were diagnosed with PSD were recruited and randomly assigned to the control group (n = 50) or the TMS group (n = 50). The controls were given citalopram (10 mg/d for consecutive 8 weeks), while, in addition to citalopram, patients in the TMS group were also given TMS at 5 Hz once a workday for 8 weeks. The primary outcome was patient depression status as reflected by 17-item Hamilton Rating Scale for Depression (HAMD-17) score, and the secondary outcome was patient neuropsychological score determined by Mini-Mental State Examination (MMSE) and Wisconsin Card Sorting Test (WCST).ResultsPatients treated with TMS in combination with citalopram had a drastic decrease in HAMD-17 score during treatment. Bigger changes in HAMD-17 score between baseline and 2 weeks as well as between baseline and 8 weeks in the TMS group were observed (P < 0.01). Patients in both groups had increased MMSE scores after treatment. Data of WCST revealed patients with TMS treatment completed more categories (P < 0.01) and had a lower RPP in comparison to patients in the control group (P < 0.0001). Additionally, TMS in combination with citalopram strikingly improved patients' MMSE scores when compared with those taking citalopram alone. Last, there was no striking difference in side effects between the two groups (P > 0.05).ConclusionOur study found TMS in combination with citalopram is conducive to improving depression status and neuropsychological function, which holds great promise for treating PSD.

Arterial hypertension, cognitive decline and cerebrovascular damage

Abstract Introduction Arterial hypertension has been associated with increased risk of cognitive dysfunction (CD) and dementia explained by the onset of cerebral microvascular disease. However, it is not well known which are true markers of cognitive decline and how to demonstrate them. Purpose We aimed to evaluate cognitive functions and study microvascular disease with cerebral localization in hypertensive patients. Methods Patients over 50 years with arterial hypertension were included. Cognitive status was assessed by using the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests. We selected 50 patients in two groups: 25 patients with mild CD (MoCA &amp;lt;26 points, MMSE &amp;gt;24 points), respectively 25 patients without CD (MoCA ≥26 points, MMSE ≥24 points). In these groups, magnetic resonance imaging (MRI) using GE Optima MR450w 1.5 Tesla of the brain was performed. MRI images with the RadiAnt program were studied and ImageJ was used to measure the area of the thalamus with a method developed by our team, by calculating the total area and hyperintense areas (microvascular damage) in number of pixels. For statistical analysis IBM-SPSS v.26 program was used. Results 585 consecutive hypertensive patients were enrolled, mean age 67.9±9.5 years, 52.1% women, mean blood pressure 135/80±20/11 mmHg (with antihypertensive treatment). The MoCA test identified cognitive impairment in 66.1% of participants (mean scores 20.66±3.9) while the MMSE in 17.1% (mean scores 20.64±3.0). In the subgroup of 50 patients, the mean age was 70.9±5.5 years for the CD group and 69.9±3.9 years for the group without CD (p=0.4, between 59–79 years). No significant difference was detected between groups in mean blood pressure, ambulatory blood pressure, and hypertension duration (18.0±12 years vs. 17.7, p=0.9). Cerebrovascular disease was detected in 48 patients by brain MRI. There was no statistically significant difference between the two groups. The most frequent changes were white matter hyperintensities in 89.6%, enlarged perivascular spaces in 77.1%, and lacunar infarcts in 52.1%. In three cases silent brain infarct was unmasked. In 45 patients, we applied the modified measurement of the thalamic area and a statistically significant difference was detected in the right thalamus area in patients with CD (p=0.009) compared to patients without CD (on the left side p=0.058). Conclusions CD and cerebral microvascular changes were frequently present in hypertensive patients with associated cardiovascular disease in the studied group. At the level of the thalamus with the method developed by our team, we demonstrated that microvascular alterations on the right side are associated with cognitive decline. The methodology developed for the quantitative measurement of the injured thalamic area proved to be objective and repeatable. The innovative method, the analysis of imaging data with pixels is a promising way to continue the research. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Hungarian Academy of Science

DAMOCLES project show that cognitive function is a strong determinant of the influence of self-care behavior on health-related quality of life in patients with heart failure

Abstract Background Poor self-care is associated with a poorer outcomes in patients with heart failure (HF). Psycho-social factors are determinants of patient-reported outcomes (PROMs) such as health-realted quality of life (QoL). However, little is known about the interplay between self-care and psychosocial factors such as cognitive function on PROMs in patients with HF. Purpose Describe the effect of self-care on QoL across cognitive function and explore whether the interaction between self-care and cognitive function may account for this effect. Methods 1120 patients with chronic HF from DAMOCLES study were analyzed. We used the modified European Heart Failure Self-care Behaviour Scale 9-item version (EHFSCBS-9) to measure self-care (inverted and standardised: higher scores indicate better self-care). To assess QoL, we used Minnesota Living with Heart Failure Questionnaire (MLHFQ) (higher scores indicate worse QoL). Cognitive function was evaluated using Mini-Mental State Examination (MMSE) and Short Portable Mental State Questionnaire (SPMSQ) Tests. Cognitive impairment was defined as abnormal age-and-literacy-adjusted scores. General linear models (GLM) were constructed to explore the interaction between cognitive function and poor self-care (defined as EHFSCBS-9 ≤lower tertile) on adjusted MLHFQ scores. To determine the impact self-care, multivariate linear regressions models to predict QoL were constructed stratified according to cognitive function. All models were adjusted by determinants of HF severity. Results Mean age was 72±11 years, 43% were women and mean LVEF was 45±17%. Lower MMSE scores (β=−0,163; p-value &amp;lt;0.001) and &amp;gt;3 errors in the SPMSQ indicating cognitive impairment (β=0.071; p-value = 0.023) were associated with higher scores in the MLHFQ. These associations were confirmed in multivariare linear regression models (β=0.062; p-value = 0.038). In adjusted GLM, poor global self-care (F=4.8; p-value = 0.029) was an independent predictor of higher adjusted scores in the MLHFQ. Interaction term poor self-care by cognitive impairment was significantly associated with MLHFQ scores (F=6.0; p-value=0.014; Figure 1). Multivariate linear regresion models (Table 1) stratified according the absence (panel A) or the presence (panel B) of cognitive impairment showed that cognitive function modulates the association between self-care behaviour and QoL. This effect was only seen in patients without cognitive impairment. In patients with cognitive dysfunction, self-care behaviour did not longer influence self-perceived health status in patients with HF. Conclusions Self-care behaviour is an independent predictor of PROMs in HF regardless cognitive disfunction. Cognitive function modulates 1) influence of global self-care and each one of its dimensions on emotional QoL and 2) impact of global self-care and consulting behaviour on global and social QoL. Funding Acknowledgement Type of funding sources: None.

Epilepsy, Vascular Risk Factors, and Cognitive Decline in Older Adults: The Cardiovascular Health Study.

Recent studies have shown that global cognitive ability tends to decline faster over time in older adults (≥65 years) with epilepsy compared with older adults without epilepsy. Scarce data exist about the role of vascular risk factors (VRFs) on cognitive course in epilepsy. We assessed whether the associations of individual VRFs with cognitive trajectory differed depending on the presence of prevalent epilepsy. The Cardiovascular Health Study is a population-based longitudinal cohort study of 5,888 US adults aged ≥65 years. Cognitive function was assessed annually with modified Mini-Mental State Examination (3MS; global cognitive ability) and Digit Symbol Substitution Test (DSST; information processing speed). We used linear mixed models to estimate the individual and joint associations of epilepsy and VRFs with cognitive decline by modeling epilepsy × VRF interactions one by one, each adjusted for all other VRFs considered, including demographics, health behaviors, clinical characteristics, and comorbid diagnoses. From these models, we estimated excess mean cognitive decline due to interaction of epilepsy with each VRF. We observed excess mean decline in global cognitive ability (3MS) due to interactions of epilepsy with hypertension (6.6 points greater mean 8-year decline than expected if no interaction; 95% CI 1.3-12.0) and with abstaining from alcohol (5.8 points greater than expected; 95% CI 0.3-11.3). We also observed excess mean decline in information processing speed (DSST) due to interactions of epilepsy with prior stroke (18.1 points greater mean 9-year decline than expected; 95% CI 7.6-28.5), with abstaining from alcohol (6.1 points greater than expected; 95% CI 2.5-9.8), and with higher triglyceride levels (2.4 points greater than expected per SD; 95% CI 0.4-4.3). Associations of some VRFs with cognitive decline in older adults are stronger in the presence of epilepsy, suggesting a need for greater attention to vascular protection for preserving brain health in older adults with epilepsy.

Therapeutic Effects of Low-Level Laser Therapy on Cognitive Symptoms of Patients with Dementia: A Double-Blinded Randomized Clinical Trial.

Objective: To investigate the effects of low-level laser therapy (LLLT) as a new nonpharmaceutical approach to improve cognitive symptoms in patients with dementia. Background: Routine pharmacological treatment of dementia patients is inefficient and has considerable adverse effects. Recent attempts to develop nonpharmaceutical approaches are considered favorable for patients with dementia. Methods: Thirty-two patients with dementia were randomly divided into the same population of LLLT and sham groups. The LLLT group underwent transcranial LLLT, and the sham group received the same protocol with a zero-intensity laser. All patients in the two groups were evaluated using the minimental state examination (MMSE) and clinical dementia rating (CDR) tests at the time of admission as baseline at 2 and 6 weeks postintervention. Results: The rate of change of MMSE scores in sham and LLLT groups was 0.13 ± 0.96 and 2.31 ± 1.81 in week 2 (p = 0.00005) and also -0.25 ± 0.86 and 2.53 ± 1.73 in week 8 (p = 0.000003). In the LLLT group, the mean scores of CDR were 1.28 ± 0.71, 1.28 ± 0.71, and 1.25 ± 0.80 at baseline, week 2, and week 8 (p = 0.605 and p = 0.742), respectively. The mean scores of CDR in the sham group were 1.69 ± 0.73, 1.75 ± 0.68, and 1.72 ± 0.82 at baseline, week 2, and week 8, respectively. Conclusions: These findings suggest that laser therapy could be a promising treatment modality and an adjunct to pharmacotherapy in dementia patients. Clinical Trial Registration: IRCT20191018045148N1 was obtained from the Iranian Registry of Clinical Trials (IRCT.ir).

Predicting Mini-Mental State Examination Scores Using Electroencephalography Signal Features

Purpose: The purpose of this study is to use linear and non-linear features extracted from Electroencephalography (EEG) signal to predict the Mini-Mental State Examination (MMSE) test score by machine learning algorithms.&#x0D; Materials and Methods: First, the MMSE test was taken from 20 subjects that were referred with the initial diagnosis of dementia. Then, the brain activity of subjects was recorded via EEG signal. After preprocessing this signal, various linear and non-linear features are extracted from it that are used as input to machine learning algorithms to predict MMSE test scores in three levels.&#x0D; Results: Based on the experiments, the best classification result is related to the Long Short-Term Memory (LSTM) network with 68% accuracy.&#x0D; Conclusion: Findings show that by using machine learning algorithms and features extracted from EEG signal the MMSE scores are predicted in three levels. Although deep neural networks require a lot of data for training, the LSTM network has been able to achieve the best performance. By increasing the number of subjects, it is expected that the classification results will also increase.

Effect of computerized cognitive rehabilitation in comparison between young and old age after traumatic brain injury.

Introduction:Cognitive dysfunction reduces patients’ quality of life and social participation with traumatic brain injury (TBI). Computerized cognitive rehabilitation is increasingly being used for cognitive therapy in TBI patients. The purpose of this study was to investigate the influence of age on the effect of computerized cognitive rehabilitation in cognitive dysfunction after TBI.Material and methods:A total of 34 patients with cognitive dysfunction after TBI were enrolled. Participants performed 30 sessions of computerized cognitive rehabilitation (Comcog) for 6 weeks. A cognitive evaluation was performed before and after treatment with Mini-Mental State Examination (MMSE) and Computerized Neurophyschologic Test (CNT).Results:There were no cognitive tests that differed between the young group and the old group at baseline. However, after computerized cognitive rehabilitation, the young group showed significant improvement compared to the old group in verbal memory, visual memory, attention, and visuo-motor coordination tests. The young group showed improvement in MMSE, verbal and visual memory, and visuo-motor coordination tests after computerized cognitive rehabilitation. In contrast, the old group showed significant improvement only in MMSE and visual learning test, one of the visual memory tests.Conclusion:Our findings demonstrate that age may be an important factor related to the effect of computer cognitive rehabilitation on cognitive dysfunction after TBI. Methodologically more ordered studies with larger sample sizes are needed in the future.

Cognitive assessment in the time of pandemics: mandatory surgical face mask usage affects cognitive test performance of older adults.

The most important disadvantage of surgical mask usage is that it can aversely affect communication. This study aimed to evaluate the possible effects of face masks on the cognitive test performance of older adults. A total of 198 geriatric patients were enrolled after applying the exclusion criteria. Within the comprehensive geriatric assessment (CGA), cognitive status assessment was performed with the Mini-Mental State Examination test (MMSE) and Quick Mild Cognitive Impairment Screening test (Q-MCI) tests. The median age was 70 (66-77) years, and there were 119 female (60.7%) patients. Patients were divided into normal cognitive status (NC), mild cognitive impairment (MCI), and probable Alzheimer's disease (AD) groups. There were 129 (65.2%), 30 (15.2%), and 37 (18.7%) patients in each group, respectively. For differentiating MCI from NC, calculated optimal cut-offs for the Q-MCI and MMSE total scores were ≤50 (sensitivity 83.3%, specificity 90.7%) and ≤26 (sensitivity 63.3%, specificity 87.5%), respectively. For differentiating AD from MCI, calculated optimal cut-offs for the Q-MCI and MMSE total scores were ≤28 (sensitivity 76.8%, specificity 86.7%), and ≤24 (sensitivity 94.4%, specificity 64.5%), respectively. Our results revealed that screening tests are still sensitive in discriminating cognitive disorders although cut-offs are lower with mask usage than for previously validated cut-offs. This is the first study revealing the impact of surgical mask usage on cognitive test performance, indicating that cut-offs validated before the pandemic may cause overdiagnosing of cognitive disorders since the previous cut-offs are not validated for mask usage. Large sample studies are needed to determine new cut-offs validated with mask usage.

12/15-Lipoxygenase Regulation of Diabetic Cognitive Dysfunction Is Determined by Interfering with Inflammation and Cell Apoptosis

This study aimed to discuss the role of 12/15-lipoxygenase (12/15-LOX) regulation involved in diabetes cognitive dysfunction. First, Mini Mental State Examination (MMSE) test was used to evaluate cognitive ability in diabetic patients and normal controls. The plasma test showed that the plasma level of 12/15-LOX in patients with MMSE scores below 27 was significantly increased compared with that of the normal group. Second, 12/15-LOX inhibitor was administered to diabetic rats. Behavioral tests, biochemistry, enzyme-linked immunosorbent assays, and Western blotting were used in this study. We found that the levels of fasting and random blood glucose increased rapidly in diabetic rats, the levels of triglycerides and total cholesterol in the diabetic group increased, and insulin levels decreased significantly. In the Morris water maze test, the escape latency was prolonged, and the crossing times decreased in the diabetic group. Under the microscope, the apoptosis of hippocampal neurons in diabetic rats increased significantly. The levels of TNF-α, IL-6 and 12-hydroxyindoleic acid (12(S)-HETE) significantly increased, and the protein expression of 12/15-LOX, p38 MAPK, Aβ1-42, caspase-3, caspase-9 and cPLA2 increased, while that of Bcl-2 decreased. However, the use of 12/15-LOX inhibitor reversed these results. Third, 12/15-LOX shRNA and p38MAPK inhibitor were administered to HT22 cells in high-glucose medium. The results of the cell experiment were consistent with those of the animal experiment. Our results indicated that the 12/15-LOX pathway participates in diabetic brain damage by activating p38MAPK to promote inflammation and neuronal apoptosis, and intervention 12/15-LOX can improve diabetic cognitive dysfunction.

Lower Preoperative Verbal Memory Performance Is Associated with Delirium after Coronary Artery Bypass Graft Surgery: A Prospective Cohort Study.

Cognitive impairment constitutes one of the major risk factors of delirium after coronary artery bypass graft (CABG) surgery; however, it is unclear whether only patients with global cognitive decline are at increased risk for delirium or if individuals with preserved global cognitive functions but impairments in specific cognitive domains are also more vulnerable to developing delirium. Thus, this study aimed to analyze the neurocognitive status of patients scheduled for CABG surgery with the use of an advanced computerized cognitive battery (CNS Vital Signs) and to investigate possible associations between impaired performance in selective cognitive areas and the risk of postoperative delirium development. The study enrolled 127 participants with a median age of 67years (IQR: 63-71). Postoperative delirium developed in 32 (25%) patients.Before surgery, the patients were screened for global cognitive impairment with the use of the Mini-Mental State Examination Test, and the individuals were asked to perform the CNS Vital Signs battery to investigate 12 specific cognitive domains. The Confusion Assessment Method and the Memorial Delirium Assessment Scale were used to screen for a diagnosis of delirium postoperatively. In multivariate models, a lower score of verbal memory-assessed preoperatively was independently associated with the risk of postoperative delirium development. Other independent predictors of delirium included more advanced age, gender female, depression, postoperative pyrexia, and the presence of extracorporeal circulation. As decreased verbal memory constitutes an independent risk factor for postoperative delirium, a verbal memory test may be a useful predictor of postoperative delirium development.

Trajectories of cognitive and physical performance after accidental falls in nursing home residents: A prospective study

This prospective study evaluated cognitive and physical trajectories of nursing home (NH) residents after fall occurrence and their predictors. In 167 residents aged ≥60, we considered the closest pre-fall assessment and up to the first three post-fall assessments of cognitive and physical functions performed through Mini-Mental State Examination (MMSE) and Tinetti tests. Mixture models identified three post-fall cognitive and physical trajectories: stability, slow decline, and rapid decline. At logistic regression, older age, fewer informal visits, and falls within one month from institutionalization increased the probability of experiencing a decline in MMSE and Tinetti scores. Worse pre-fall cognitive function increased the likelihood of cognitive and physical decline, while worse pre-fall Tinetti score negatively impacted only physical decline.In conclusion, the impact of falls on the cognitive and physical health of NH residents may be modulated by their pre-fall cognitive function and some modifiable factors, such as social interactions and physical function.

Effects of Tianeptine Treatment on Depression and Cognitive Function in Patients with Alzheimer's Disease: A 12-Month Retrospective Observational Study.

Background:Depression is a common manifestation in Alzheimer’s disease (AD). In clinical practice, antidepressant medication is often used for depression in AD.Objective:We explore the effectiveness of the atypical antidepressant tianeptine compared with other conventional antidepressants in AD patients with depression in a real-life setting.Methods:We retrospectively identified 126 AD patients who had received antidepressant treatment for 12 months with tianeptine or other antidepressants. Subjects were divided into two groups according to the treatment they had received: tianeptine group (n = 38) or other antidepressant group (n = 88). Drug effects on depression, cognition, behavior, and functional performance were evaluated at baseline, 6, and 12 months. A Mixed Effects Model Analysis was carried out to evaluate changes in performance scores.Results:Both tianeptine and other antidepressants showed an antidepressant effect after 12 months with significant improvement on the Cornell Scale for Depression in Dementia, the Hamilton Depression Rating Scale, and the Neuropsychiatric Inventory-Depression subscale. A statistically significant improvement at 12 months was shown in the tianeptine group versus the other antidepressants group on most of the cognitive measures such as the Mini-Mental State Examination, the Letter and Category Fluency Test, the Rey Auditory Verbal Learning Test, and the Boston Naming Test.Conclusion:Our results suggest that tianeptine reduces depressive symptoms and improves cognition in AD patients. This could be considered clinically relevant and should inspire the design of future long-term randomized controlled trials that contribute to supporting the use of tianeptine for improving cognitive function in AD patients.

Platelet-Derived Amyloid-β Protein Precursor as a Biomarker of Alzheimer's Disease.

Platelet proteins may be associated with Alzheimer's disease (AD) pathology. To investigate the relationship between platelet proteins and cerebrospinal fluid (CSF) biomarkers of AD and cognition in individuals with memory decline to identify effective screening methods for detecting the early stages of the disease. We classified 68 participants with subjective memory decline according to the ATN framework determined by CSF amyloid-β (A), CSF p-tau (T), and t-tau (N). All participants underwent Mini-Mental State Examination (MMSE) and platelet-related protein content testing. Eighteen participants had normal AD biomarkers (NCs), 24 subjects had non-AD pathologic changes (non-AD), and 26 subjects fell within the Alzheimer's continuum (AD). The platelet amyloid-β protein precursor (AβPP) ratio in the AD group was significantly lower than in the non-AD and NCs groups, and positively correlated with MMSE scores and CSF amyloid-β42 level, which could affect MMSE scores through CSF amyloid-β42. Levels of platelet phosphorylated-tau 231 and ser396/404 phosphorylated tau were elevated in both AD and non-AD compared to NCs. Additionally, the receiver operating characteristic analysis demonstrated that the platelet AβPP ratio was a sensitive identifier for differentiating the AD from NCs (AUC = 0.846) and non-AD (AUC = 0.768). And ser396/404 phosphorylated tau could distinguish AD from NCs. Our study was the first to find an association between platelet AβPP ratio and CSF biomarkers of AD, which contribute to the understanding of the peripheral changes in AD. These findings may help to discover potential feasible and effective screening tools for AD.

Evaluation of the Effectiveness of an Herbal Formulation of Boswellia sacra Flueck. In Improving Cognitive and Behavioral Symptoms in Patients with Cognitive Impairment and Alzheimer's Disease.

This study aimed to assess the efficacy of an herbal formulation based on Boswellia sacra in improving cognitive and behavioral symptoms in patients with mild cognitive impairment (MCI) and mild-to-moderate stages of Alzheimer's disease (AD). A 3-month, parallel-group, placebo-controlled trial was implemented from October 2021 to April 2022. Patients with MCI and mild-to-moderate stages of AD aged above 50 years (n = 60; 40 women, 20 men) enrolled in the study using clinical diagnosis and a score of 10-30 on the mini-mental state examination (MMSE) test. They were assigned into two groups; one receiving a herbal formulation) include B. sacra, Melissa officinalis, Piper longum, Cinnamomum verum, and Physalis alkekengi) three times a day and the other receiving a placebo for 3 months. The main efficacy measures were the changes in cognitive domains based on the MMSE and changes in behavioral and psychiatric symptoms based on neuropsychiatric inventory (NPI) scores compared with baseline. Side effects were also recorded. Results of this study showed significant differences between the two groups after 3 months in terms of all the assessed variables, including the overall result of the mean score of MMSE and NPI tests (P ≤ 0.001). The herbal formulation had the most considerable effects on the domains of orientation, attention, working memory, delay recall, and language of the MMSE test. Herbal formulation based on B. sacra was significantly effective compared to a placebo in improving cognitive and behavioral symptoms in patients with MCI and mild-to-moderate AD.

Prediction of the cognitive impairment development in patients with autoimmune thyroiditis and hypothyroidism.

Objective. The aim of the present work is to define the risk factors that can affect the presence of a cognitive impairment and analyze the associations of the brain-derived neurotrophic factor (BDNF) gene polymorphism (rs6265), vitamin D receptor (VDR) gene polymorphism (rs2228570), and N-methyl-D-aspartate (NMDA) receptor gene polymorphism (rs4880213) with the cognitive impairment in patients with autoimmune thyroiditis and hypothyroidism in the Western Ukraine population and predict the development of cognitive disorders in these patients. Methods. The study involved 153 patients with various forms of thyroid pathology (hypothyroidism, autoimmune thyroiditis, elevated serum antibodies anti-thyroglobulin and anti-thyroid peroxidase). Cognitive impairment in the examined patients was evaluated based on the results of the Mini-Mental State Examination (MMSE) test. BDNF, GRIN2B, and 25-OH Vitamin D levels in the serum of the patients and healthy individuals were quantified using highly sensitive commercial enzyme-linked immunosorbent assay kits. Genotyping of the VDR (rs2228570), BDNF (rs6265), and NMDA receptor (rs4880213) gene polymorphism was performed using TaqMan probes and Taq-Man Genotyping Master Mix (4371355) on CFX96™Real-Time PCR Detection System. Polymerase chain reaction (PCR) for TaqMan genotyping was carried out according to the kit instructions. Results. Strong direct relationship between the "Level GRIN2B" and cognitive impairments (p=0.006) was established after evaluating the complex model based on the values of the regression coefficient. An increase in the likelihood of cognitive impairment by 24.898-fold (p=0.012) was seen after assessing the effect of the CT rs6265 genotype. In addition, direct relationship between the influence of the TT rs6265 genotype and an increase in the likelihood of cognitive impairment by a factor of 21.734 (p=0.024) was also established. Conclusion. The present data indicate that the BDNF, TSH, fT4, and vitamin D levels prognostically belong to the significant indicators of the cognitive impairment development.

The Association Between Cancer and Alzheimer's-Type Neuropathology: A Community-Based Cohort Study

Background: Cancer and Alzheimer's disease are common diseases in aging populations. Intriguingly, prior research has reported a lower incidence of Alzheimer's disease dementia among individuals with a history of cancer. Both are prevalent and lethal conditions. The current study was conducted to investigate the association of cancer history with neuropathological and cognitive features. Methods: Data were drawn from elderly, longitudinally evaluated participants in a community-based cohort study of aging and dementia who came to autopsy at the University of Kentucky Alzheimer's Disease Research Center. The data were linked to the Kentucky Cancer Registry, which is a population-based state cancer surveillance system, to obtain cancer-related data. We examined the relationship between cancer history, clinical dementia diagnoses, Mini-Mental State examination test scores, and neuropathological features using inverse probability weighting to address confounding and selection bias. Results: Included participants (n = 785) had a mean ±SD age of death of 83.8 ±8.6 years; 60.1% were female. Positive cancer history was determined in 190 (24.2%) participants. The prevalence of at least one APOE ε4 allele was lower among participants with cancer history compared to cancer-free participants (32.6% vs 42.0%, P = 0.0063). Participants with cancer history had lower odds of MCI/Dementia, and higher cognitive test scores (e.g., comparing MMSE scores evaluated at six and &amp;lt; two years prior to death., P &amp;lt; 0.001). Cancer history was also associated with reduced odds of intermediate (III/IV) or severe (V/VI) Braak Neurofibrillary tangle stages, moderate/frequent neuritic plaques, moderate/frequent diffuse plaques, and moderate/severe cerebral amyloid angiopathy (all P&amp;lt;0.05). By contrast, TDP-43, √é±-synuclein, and cerebrovascular pathologies were not associated with cancer history. Conclusion: In this study, we showed that cancer history was associated with a lower burden of Alzheimer's disease pathology and clinical dementia. These findings provide an additional basis of support for prior epidemiological research reporting a protective association between cancer and Alzheimer's disease-type dementia.

Cognitive assessment in patients with myotonic dystrophy type 2

Myotonic dystrophy type 2 (DM2) is an autosomal dominant multisystemic disorder. Previous studies conducted on small cohorts of DM2 patients indicated presence of a cognitive dysfunction. We aimed to assess cognitive functions in a larger cohort of Serbian DM2 patients using an extensive battery of neuropsychological tests. The study included 76 patients with a genetically confirmed DM2, 68 of whom had all tests for different cognitive domains performed. Patients underwent clinical and neuropsychological testing, including cognitive screening and assessment of general intellectual level, attention, executive and visuospatial abilities, memory, and language functions. Only 6% of patients achieved a below-average score on the general intellectual level test. Cognitive screening tests indicated presence of cognitive deficits in 5.5% of patients according to the Mini Mental State Examination test and 25.8% according to the Addenbrooke's Cognitive Examination Revised test. Twenty-four (35.3%) patients had a cognitive impairment (being two standard deviations out of norm in at least two cognitive domains). Around one quarter of DM2 patients had a significant cognitive impairment that interfered with their everyday functioning. Patients with significant cognitive impairment were older at testing and at disease onset, less educated, and had more severe muscle weakness.

Evaluation of cognitive, mental, and sleep patterns of post-acute COVID-19 patients and their correlation with thorax CT.

ObjectiveIn this study, we have evaluated the cognitive, mental, and sleep patterns of post-COVID patients 2 months after their hospitalization, and after scoring their hospitalization thorax CTs, we have compared the degree of the lung involvement with cognitive and mental states of the patients.Materials and methodsForty post-COVID patients were included in our study. Patients who were hospitalized due to COVID-19 and who had thorax CT scan at the admission were included in the study. Thorax CT scans of the patients were scored using chest severity scoring (CT-SS). The Mini-Mental State Examination test (MMSE), the Montreal Cognitive Assessment Test (MoCA), the Pittsburgh Sleep Quality Index, and the Hamilton Depression and Hamilton Anxiety scales of all the participants were evaluated by the same person.ResultsEarly stage cognitive impairment was detected in 15% of post-COVID patients in the MMSE test and mean MMSE test score was 26.9 ± 2.1. The MoCA test detected cognitive impairment in 55% of the patients, and the mean MoCA score was 19.6 ± 5.2. Furthermore, all patients showed depressive symptoms in Hamilton Depression Scoring System and 57.5% of the patients showed anxiety symptoms in the Hamilton Anxiety Scoring System. The mean Pittsburg Sleep Quality Index of the patients was 10.7 ± 3.1, and it was found to be higher than normal. The mean CT-SS scores, which used to evaluate the lung involvement, of the patients were 4.7 ± 5.6. We did not find any correlation between patients’ cognitive tests and CT-SS scores.ConclusionWhen these results are taken into consideration, our study has shown that the neuropsychiatric symptoms of the patients who had COVID-19 continued even after 2 months of their illness. Therefore, long-term rehabilitation of these patients, including cognitive education and psychological services, should be continued.